| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
204,109 |
202,056 |
$5.83M |
| S0620 |
Routine ophthalmological exa |
102,826 |
102,247 |
$4.92M |
| S0621 |
Routine ophthalmological exa |
94,618 |
94,134 |
$4.74M |
| 92340 |
|
195,742 |
192,614 |
$3.79M |
| V2100 |
Lens spher single plano 4.00 |
88,517 |
80,280 |
$1.03M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
115,198 |
79,360 |
$844K |
| 92004 |
|
9,109 |
8,980 |
$561K |
| 92341 |
|
26,081 |
25,515 |
$552K |
| 92014 |
|
10,034 |
9,875 |
$540K |
| 99213 |
|
9,261 |
8,424 |
$418K |
| V2200 |
Lens spher bifoc plano 4.00d |
17,758 |
16,307 |
$288K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
29,623 |
20,209 |
$288K |
| V2784 |
Lens polycarb or equal |
57,518 |
56,785 |
$223K |
| 99212 |
|
7,352 |
6,669 |
$220K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
15,005 |
11,614 |
$163K |
| 92015 |
|
18,761 |
18,516 |
$161K |
| V2107 |
Spherocylinder 4.25d/12-2d |
12,998 |
9,829 |
$137K |
| 99203 |
|
1,764 |
1,752 |
$109K |
| 99202 |
|
2,564 |
2,549 |
$104K |
| 92083 |
|
2,005 |
1,975 |
$70K |
| 99214 |
|
838 |
801 |
$52K |
| 92133 |
|
1,957 |
1,944 |
$39K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
2,802 |
2,301 |
$30K |
| 92134 |
|
1,429 |
1,408 |
$27K |
| V2410 |
Lens variab asphericity sing |
1,442 |
1,432 |
$26K |
| V2101 |
Single visn sphere 4.12-7.00 |
2,939 |
2,472 |
$25K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
1,999 |
1,668 |
$24K |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
2,023 |
1,579 |
$22K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
1,967 |
1,602 |
$22K |
| V2207 |
Lens sphcy bifocal 4.25-7d/. |
1,538 |
1,191 |
$20K |
| 92250 |
|
473 |
467 |
$13K |
| V2744 |
Tint photochromatic lens/es |
5,240 |
5,142 |
$5K |
| 92310 |
|
211 |
210 |
$4K |
| V2781 |
Progressive lens per lens |
5,368 |
5,248 |
$3K |
| V2300 |
Lens sphere trifocal 4.00d |
72 |
71 |
$2K |
| V2112 |
Spherocylindr 7.25d/2.25-4d |
96 |
79 |
$1K |
| 92342 |
|
85 |
84 |
$970.43 |
| 76514 |
|
125 |
124 |
$952.54 |
| 92012 |
|
13 |
13 |
$617.43 |
| 92071 |
|
13 |
12 |
$275.40 |
| V2208 |
Lens sphcy bifocal 4.25-7/2. |
15 |
12 |
$201.76 |
| V2745 |
Tint, any color/solid/grad |
414 |
403 |
$185.84 |
| V2750 |
Anti-reflective coating |
18,171 |
17,910 |
$149.15 |
| V2109 |
Spherocylinder 4.25d/4.25-6d |
13 |
12 |
$138.71 |
| V2755 |
Uv lens/es |
1,032 |
1,015 |
$49.00 |
| V2499 |
Variable asphericity lens |
39 |
39 |
$42.72 |
| G8785 |
Bp scrn no perf at interval |
1,129 |
1,051 |
$0.00 |
| G8421 |
Bmi not calculated |
568 |
500 |
$0.00 |
| 2022F |
|
280 |
279 |
$0.00 |
| M1210 |
>=2 same meds tbl4 not ord |
60 |
60 |
$0.00 |
| G9368 |
>= 2 same hi-rsk med not ord |
261 |
255 |
$0.00 |
| G2102 |
Dil retinal eye exam |
28 |
28 |
$0.00 |
| 2023F |
|
411 |
408 |
$0.00 |
| G8732 |
No doc of pain |
663 |
645 |
$0.00 |
| G8428 |
Cur meds not document |
2,245 |
2,139 |
$0.00 |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
837 |
830 |
$0.00 |
| G8756 |
No bp measure doc |
14 |
14 |
$0.00 |
| M1208 |
Pt no scrn sdoh |
90 |
87 |
$0.00 |
| G9366 |
1high risk no ord |
31 |
30 |
$0.00 |