| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
24,743 |
23,138 |
$1.37M |
| V2020 |
Vision svcs frames purchases |
20,631 |
20,503 |
$1.22M |
| 92014 |
|
22,948 |
21,629 |
$1.17M |
| 99214 |
|
18,893 |
16,666 |
$1.01M |
| J0178 |
Aflibercept injection |
1,125 |
782 |
$765K |
| 66984 |
|
3,099 |
2,196 |
$648K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
11,127 |
11,066 |
$587K |
| 99204 |
|
5,933 |
5,304 |
$491K |
| 99213 |
|
12,534 |
10,334 |
$485K |
| 92015 |
|
45,022 |
41,538 |
$324K |
| V2100 |
Lens spher single plano 4.00 |
8,958 |
8,837 |
$307K |
| V2025 |
Eyeglasses delux frames |
4,851 |
4,844 |
$243K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
3,352 |
3,348 |
$242K |
| 67028 |
|
3,185 |
2,234 |
$145K |
| 92134 |
|
5,608 |
4,678 |
$105K |
| 92250 |
|
4,202 |
3,610 |
$80K |
| 92133 |
|
3,896 |
3,433 |
$80K |
| 92136 |
|
3,337 |
2,648 |
$71K |
| 92083 |
|
1,728 |
1,534 |
$55K |
| 99203 |
|
587 |
563 |
$42K |
| J9035 |
Bevacizumab injection |
945 |
648 |
$40K |
| V2784 |
Lens polycarb or equal |
6,055 |
5,821 |
$40K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
528 |
526 |
$24K |
| V2200 |
Lens spher bifoc plano 4.00d |
421 |
421 |
$22K |
| 92012 |
|
501 |
418 |
$17K |
| V2107 |
Spherocylinder 4.25d/12-2d |
282 |
281 |
$15K |
| 83861 |
|
1,685 |
658 |
$13K |
| 92285 |
|
737 |
652 |
$9K |
| 66821 |
|
109 |
65 |
$9K |
| 99212 |
|
221 |
176 |
$4K |
| 92002 |
|
58 |
55 |
$4K |
| V2760 |
Scratch resistant coating |
182 |
181 |
$1K |
| 99202 |
|
31 |
30 |
$1K |
| V2781 |
Progressive lens per lens |
27 |
27 |
$1K |
| 68761 |
|
31 |
12 |
$1K |
| V2750 |
Anti-reflective coating |
152 |
130 |
$1K |
| 92025 |
|
35 |
29 |
$623.70 |
| 92020 |
|
29 |
27 |
$369.40 |
| 76514 |
|
59 |
52 |
$364.66 |
| 92310 |
|
12 |
12 |
$87.11 |
| V2755 |
Uv lens/es |
39 |
30 |
$8.66 |
| V2744 |
Tint photochromatic lens/es |
13 |
13 |
$0.00 |
| 2023F |
|
12 |
12 |
$0.00 |
| 99199 |
|
797 |
797 |
$0.00 |