| Code | Description | Claims | Beneficiaries | Total Paid |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
16,722 |
8,559 |
$543K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
12,085 |
5,806 |
$216K |
| 93797 |
|
3,527 |
631 |
$141K |
| V2020 |
Frames, purchases |
9,196 |
8,749 |
$68K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
491 |
430 |
$35K |
| Q3014 |
Telehealth originating site facility fee |
2,053 |
2,008 |
$28K |
| J0178 |
Injection, aflibercept, 1 mg |
60 |
49 |
$25K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,211 |
1,195 |
$25K |
| V2201 |
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens |
1,048 |
515 |
$24K |
| 92134 |
|
1,197 |
1,128 |
$22K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,141 |
1,053 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
630 |
589 |
$20K |
| 92133 |
|
779 |
751 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
919 |
459 |
$14K |
| 80053 |
Comprehensive metabolic panel |
1,013 |
981 |
$11K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
221 |
220 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
680 |
636 |
$8K |
| 92083 |
|
143 |
137 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
314 |
309 |
$8K |
| 97803 |
|
343 |
334 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,179 |
1,153 |
$7K |
| 77080 |
|
82 |
82 |
$5K |
| 91200 |
|
239 |
231 |
$4K |
| 86200 |
|
266 |
265 |
$4K |
| 86235 |
|
54 |
54 |
$3K |
| 84439 |
|
387 |
380 |
$3K |
| 92250 |
|
88 |
82 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
139 |
66 |
$3K |
| 70486 |
|
46 |
45 |
$3K |
| 80061 |
Lipid panel |
197 |
195 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
469 |
456 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
1,323 |
1,299 |
$2K |
| 70355 |
|
131 |
131 |
$2K |
| 85027 |
|
293 |
286 |
$2K |
| 82728 |
|
176 |
173 |
$2K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
65 |
60 |
$2K |
| 83970 |
|
38 |
38 |
$2K |
| 82607 |
|
123 |
122 |
$2K |
| 80074 |
|
29 |
29 |
$1K |
| 90686 |
|
206 |
203 |
$1K |
| 83540 |
|
160 |
157 |
$1K |
| 86160 |
|
43 |
42 |
$1K |
| 81025 |
|
294 |
282 |
$1K |
| 86431 |
|
168 |
167 |
$1K |
| 86800 |
|
63 |
62 |
$1K |
| 82570 |
|
171 |
169 |
$1K |
| 86140 |
|
388 |
380 |
$1K |
| 85652 |
|
382 |
373 |
$1K |
| 83520 |
|
99 |
99 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
27 |
27 |
$947.60 |
| 86708 |
|
68 |
67 |
$882.60 |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
12 |
12 |
$813.45 |
| V2744 |
Tint, photochromatic, per lens |
85 |
82 |
$807.70 |
| G0008 |
Administration of influenza virus vaccine |
81 |
80 |
$764.04 |
| 83550 |
|
145 |
142 |
$712.06 |
| 86225 |
|
44 |
43 |
$612.00 |
| 82784 |
|
43 |
43 |
$605.65 |
| 82043 |
|
92 |
91 |
$597.33 |
| 85610 |
|
161 |
152 |
$582.31 |
| 86317 |
|
31 |
31 |
$573.20 |
| 86376 |
|
68 |
67 |
$537.11 |
| 20610 |
|
28 |
25 |
$505.40 |
| 86039 |
|
29 |
28 |
$387.00 |
| 82105 |
|
24 |
24 |
$350.19 |
| 92082 |
|
17 |
17 |
$331.25 |
| 82746 |
|
24 |
24 |
$282.61 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
26 |
24 |
$248.58 |
| 86803 |
|
12 |
12 |
$204.25 |
| 84165 |
|
12 |
12 |
$188.12 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$145.40 |
| 82962 |
|
64 |
58 |
$128.16 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
15 |
14 |
$122.94 |
| 83525 |
|
13 |
13 |
$120.95 |
| C9257 |
Injection, bevacizumab, 0.25 mg |
64 |
63 |
$75.02 |
| 81001 |
|
25 |
25 |
$74.95 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
779 |
763 |
$56.04 |
| 92015 |
Determination of refractive state |
12 |
12 |
$52.12 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
440 |
384 |
$48.18 |
| 86592 |
|
13 |
12 |
$39.00 |
| V2025 |
Deluxe frame |
75 |
75 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
29 |
29 |
$0.00 |
| 90656 |
|
43 |
43 |
$0.00 |
| 90636 |
|
12 |
12 |
$0.00 |