| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
|
141,624 |
125,817 |
$7.36M |
| 99214 |
|
86,666 |
78,441 |
$6.87M |
| 99215 |
Prolong outpt/office vis |
56,118 |
50,834 |
$6.15M |
| 99284 |
|
72,271 |
67,842 |
$4.27M |
| 99283 |
|
111,472 |
105,305 |
$3.58M |
| 99203 |
|
34,592 |
32,839 |
$2.52M |
| 99244 |
|
19,795 |
18,213 |
$2.19M |
| 99285 |
|
17,413 |
16,411 |
$1.59M |
| 99391 |
|
14,462 |
13,490 |
$1.57M |
| 99233 |
Prolong inpt eval add15 m |
22,197 |
9,244 |
$1.57M |
| 99392 |
|
11,447 |
10,868 |
$1.36M |
| 99243 |
|
18,314 |
16,915 |
$1.35M |
| 99204 |
|
11,699 |
11,099 |
$1.34M |
| 92015 |
|
31,865 |
29,583 |
$1.11M |
| 90791 |
|
11,162 |
9,229 |
$1.05M |
| 99282 |
|
36,764 |
34,992 |
$713K |
| 92004 |
|
10,366 |
9,592 |
$645K |
| 99479 |
|
6,330 |
2,263 |
$605K |
| 99469 |
|
1,922 |
686 |
$575K |
| 92014 |
|
12,273 |
11,451 |
$567K |
| 99205 |
Prolong outpt/office vis |
3,618 |
3,417 |
$558K |
| 99393 |
|
4,666 |
4,385 |
$531K |
| 90471 |
|
24,941 |
23,107 |
$508K |
| 99239 |
|
8,829 |
8,310 |
$474K |
| 95810 |
|
4,955 |
4,683 |
$463K |
| 90460 |
|
8,463 |
7,884 |
$400K |
| 99417 |
Prolong home eval add 15m |
4,536 |
4,273 |
$392K |
| 99223 |
Prolong inpt eval add15 m |
4,030 |
3,740 |
$392K |
| 99460 |
|
8,138 |
7,716 |
$351K |
| 99480 |
|
3,566 |
1,432 |
$350K |
| 99238 |
|
9,425 |
8,980 |
$347K |
| 99070 |
|
7,074 |
5,070 |
$344K |
| 96127 |
|
17,338 |
15,297 |
$342K |
| 93306 |
|
6,064 |
5,527 |
$329K |
| 99212 |
|
11,691 |
9,092 |
$312K |
| 90832 |
|
6,475 |
4,816 |
$296K |
| 00170 |
|
2,489 |
2,292 |
$290K |
| 99462 |
|
11,810 |
9,603 |
$285K |
| 99232 |
|
5,733 |
2,709 |
$284K |
| 99472 |
|
893 |
265 |
$269K |
| 99291 |
|
2,261 |
782 |
$242K |
| S0580 |
Polycarb lens |
7,797 |
7,530 |
$221K |
| 92060 |
|
7,370 |
6,836 |
$209K |
| 99245 |
|
1,560 |
1,394 |
$207K |
| 69436 |
|
1,749 |
1,625 |
$200K |
| 90472 |
|
11,483 |
10,878 |
$193K |
| 93010 |
|
42,549 |
36,942 |
$187K |
| 93303 |
|
5,103 |
4,425 |
$184K |
| V2025 |
Eyeglasses delux frames |
1,545 |
1,479 |
$182K |
| 95720 |
|
1,578 |
1,156 |
$177K |
| V2020 |
Vision svcs frames purchases |
6,109 |
5,904 |
$176K |
| 92340 |
|
7,820 |
7,547 |
$157K |
| 99394 |
|
1,274 |
1,177 |
$150K |
| 96161 |
|
6,692 |
6,175 |
$127K |
| 90847 |
|
1,478 |
1,091 |
$118K |
| 95782 |
|
1,567 |
1,472 |
$112K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,506 |
3,898 |
$111K |
| 90834 |
|
1,583 |
1,057 |
$109K |
| 42820 |
|
653 |
619 |
$102K |
| 92012 |
|
3,085 |
2,823 |
$101K |
| 99202 |
|
1,669 |
1,548 |
$98K |
| 99464 |
|
1,827 |
1,749 |
$95K |
| 99051 |
|
16,239 |
14,714 |
$93K |
| 93325 |
|
17,866 |
15,202 |
$78K |
| 96110 |
|
3,659 |
2,902 |
$77K |
| 95951 |
|
427 |
292 |
$68K |
| 31575 |
|
1,144 |
1,066 |
$68K |
| 95251 |
|
3,493 |
3,283 |
$67K |
| 93304 |
|
2,869 |
2,409 |
$64K |
| 93320 |
|
5,598 |
4,852 |
$62K |
| 92551 |
|
10,241 |
9,496 |
$59K |
| 99242 |
|
1,154 |
961 |
$56K |
| 54150 |
|
867 |
820 |
$54K |
| 99177 |
|
2,930 |
2,807 |
$54K |
| 92201 |
|
3,255 |
2,054 |
$51K |
| 93784 |
|
1,310 |
1,205 |
$50K |
| 99231 |
|
1,823 |
913 |
$49K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
2,020 |
1,790 |
$47K |
| V2100 |
Lens spher single plano 4.00 |
2,125 |
1,815 |
$46K |
| 99222 |
|
651 |
603 |
$44K |
| 99173 |
|
6,350 |
5,885 |
$42K |
| 92558 |
|
1,747 |
1,698 |
$42K |
| 93321 |
|
6,263 |
5,329 |
$34K |
| 0359T |
|
54 |
44 |
$32K |
| 93000 |
|
2,206 |
2,020 |
$31K |
| 99188 |
|
1,679 |
1,570 |
$29K |
| 93241 |
|
200 |
188 |
$28K |
| 83036 |
|
3,375 |
3,085 |
$27K |
| 96160 |
|
1,312 |
1,136 |
$22K |
| 69210 |
|
716 |
673 |
$20K |
| 90837 |
|
206 |
144 |
$18K |
| 99254 |
|
188 |
175 |
$17K |
| 91200 |
|
903 |
851 |
$17K |
| 94010 |
|
3,309 |
3,079 |
$15K |
| 43239 |
|
220 |
194 |
$15K |
| 90691 |
|
191 |
174 |
$15K |
| 93298 |
|
359 |
336 |
$15K |
| 36415 |
|
4,251 |
3,844 |
$13K |
| D0145 |
|
545 |
521 |
$13K |
| 99219 |
|
249 |
230 |
$13K |
| 92100 |
|
271 |
253 |
$12K |
| 96158 |
|
644 |
506 |
$12K |
| 92370 |
|
1,890 |
1,819 |
$12K |
| 92226 |
|
778 |
542 |
$11K |
| 36416 |
|
3,705 |
3,402 |
$11K |
| V2107 |
Spherocylinder 4.25d/12-2d |
348 |
339 |
$11K |
| 96167 |
|
526 |
476 |
$10K |
| 92511 |
|
109 |
106 |
$10K |
| 96156 |
|
863 |
814 |
$10K |
| 51784 |
|
146 |
129 |
$10K |
| 99224 |
|
398 |
332 |
$8K |
| 90474 |
|
821 |
781 |
$8K |
| 76770 |
|
160 |
154 |
$8K |
| 87880 |
|
777 |
700 |
$7K |
| 14040 |
|
45 |
40 |
$7K |
| 01922 |
|
44 |
42 |
$7K |
| 83655 |
|
574 |
563 |
$6K |
| 42830 |
|
54 |
53 |
$6K |
| 90480 |
|
175 |
153 |
$6K |
| 94060 |
|
608 |
563 |
$5K |
| 81025 |
|
1,041 |
958 |
$5K |
| 92002 |
|
128 |
127 |
$5K |
| 82962 |
|
2,782 |
2,519 |
$5K |
| 51798 |
|
615 |
536 |
$5K |
| 54161 |
|
53 |
51 |
$5K |
| 96150 |
|
150 |
145 |
$5K |
| 99253 |
|
79 |
73 |
$5K |
| 93308 |
|
244 |
219 |
$5K |
| 00126 |
|
73 |
66 |
$5K |
| 99217 |
|
121 |
107 |
$4K |
| 99211 |
|
629 |
459 |
$4K |
| 99156 |
|
97 |
88 |
$4K |
| 94664 |
|
486 |
459 |
$4K |
| 92133 |
|
145 |
136 |
$4K |
| 93245 |
|
15 |
13 |
$3K |
| 99354 |
|
73 |
70 |
$3K |
| 99220 |
|
42 |
38 |
$3K |
| 99218 |
|
108 |
97 |
$3K |
| D1206 |
|
169 |
154 |
$3K |
| 75561 |
|
41 |
39 |
$3K |
| 00731 |
|
29 |
28 |
$3K |
| V2799 |
Misc vision item or service |
78 |
78 |
$3K |
| 29075 |
|
72 |
71 |
$3K |
| 93224 |
|
34 |
30 |
$3K |
| 87804 |
|
231 |
199 |
$3K |
| 95812 |
|
54 |
49 |
$2K |
| 98968 |
|
38 |
30 |
$2K |
| 76821 |
|
120 |
107 |
$2K |
| 95819 |
|
68 |
65 |
$2K |
| 51728 |
|
15 |
12 |
$2K |
| 95816 |
|
62 |
59 |
$2K |
| 93268 |
|
15 |
12 |
$2K |
| 99381 |
|
14 |
14 |
$2K |
| 99221 |
|
59 |
37 |
$2K |
| 51797 |
|
15 |
12 |
$2K |
| 99443 |
|
34 |
30 |
$2K |
| 87636 |
|
13 |
13 |
$2K |
| 43760 |
|
15 |
13 |
$2K |
| 93018 |
|
243 |
202 |
$2K |
| 96154 |
|
81 |
80 |
$2K |
| 76820 |
|
121 |
107 |
$2K |
| 0072A |
|
38 |
37 |
$2K |
| 31526 |
|
30 |
25 |
$1K |
| 87651 |
|
53 |
50 |
$1K |
| 99255 |
|
12 |
12 |
$1K |
| 71046 |
|
139 |
121 |
$1K |
| 93296 |
|
137 |
73 |
$1K |
| 96372 |
|
88 |
87 |
$1K |
| 00635 |
|
16 |
13 |
$1K |
| 76825 |
|
26 |
25 |
$1K |
| 31231 |
|
12 |
12 |
$1K |
| 77072 |
|
135 |
121 |
$1K |
| 90686 |
|
13,858 |
12,672 |
$1K |
| 92504 |
|
80 |
77 |
$1K |
| 92225 |
|
48 |
43 |
$800.98 |
| 0071A |
|
19 |
19 |
$760.00 |
| 90717 |
|
47 |
42 |
$716.19 |
| 99157 |
|
12 |
12 |
$709.40 |
| 99241 |
|
50 |
15 |
$705.60 |
| 76700 |
|
16 |
13 |
$678.24 |
| 71555 |
|
12 |
12 |
$641.76 |
| V2101 |
Single visn sphere 4.12-7.00 |
25 |
25 |
$572.76 |
| 29065 |
|
15 |
13 |
$571.35 |
| 51741 |
|
27 |
27 |
$568.12 |
| 94760 |
|
389 |
348 |
$566.06 |
| 73610 |
|
45 |
43 |
$526.05 |
| 99442 |
|
15 |
13 |
$463.68 |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
13 |
13 |
$438.02 |
| 81003 |
|
10,598 |
9,679 |
$401.80 |
| 76827 |
|
26 |
25 |
$396.98 |
| 99251 |
|
13 |
13 |
$337.08 |
| 72082 |
|
12 |
12 |
$336.86 |
| 92285 |
|
16 |
12 |
$300.32 |
| 94200 |
|
75 |
66 |
$200.40 |
| 77080 |
|
33 |
28 |
$184.70 |
| 95012 |
|
39 |
14 |
$156.94 |
| 94780 |
|
13 |
12 |
$156.75 |
| 73140 |
|
15 |
12 |
$150.60 |
| 75565 |
|
14 |
14 |
$109.20 |
| 90656 |
|
2,384 |
2,170 |
$67.05 |
| 94781 |
|
13 |
12 |
$54.45 |
| 12011 |
|
14 |
14 |
$49.60 |
| 85018 |
|
93 |
67 |
$2.26 |
| 90671 |
|
1,403 |
1,338 |
$0.08 |
| 90697 |
|
1,793 |
1,750 |
$0.01 |
| 90744 |
|
1,231 |
1,143 |
$0.00 |
| 90698 |
|
2,764 |
2,624 |
$0.00 |
| 99000 |
|
75 |
75 |
$0.00 |
| 90677 |
|
542 |
528 |
$0.00 |
| 90839 |
|
15 |
14 |
$0.00 |
| J3535 |
Metered dose inhaler drug |
101 |
87 |
$0.00 |
| 90651 |
|
253 |
238 |
$0.00 |
| 90716 |
|
293 |
281 |
$0.00 |
| 91307 |
|
95 |
80 |
$0.00 |
| 90619 |
|
48 |
43 |
$0.00 |
| 90381 |
|
31 |
31 |
$0.00 |
| 12001 |
|
15 |
15 |
$0.00 |
| 90707 |
|
290 |
277 |
$0.00 |
| 90734 |
|
106 |
102 |
$0.00 |
| 90681 |
|
2,215 |
2,083 |
$0.00 |
| 90633 |
|
2,287 |
2,186 |
$0.00 |
| 90670 |
|
5,200 |
4,900 |
$0.00 |
| 90648 |
|
147 |
136 |
$0.00 |
| 81002 |
|
126 |
111 |
$0.00 |
| 90461 |
|
370 |
326 |
$0.00 |
| 99358 |
Prolong nursin fac eval 15m |
26 |
24 |
$0.00 |
| 90700 |
|
82 |
77 |
$0.00 |
| 90710 |
|
14 |
12 |
$0.00 |
| 91321 |
|
37 |
35 |
$0.00 |
| 91322 |
|
12 |
12 |
$0.00 |