| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
273,056 |
267,734 |
$22.23M |
| 92004 |
|
176,921 |
173,102 |
$15.62M |
| V2020 |
Vision svcs frames purchases |
357,284 |
352,030 |
$7.02M |
| 92012 |
|
29,762 |
26,721 |
$1.78M |
| 99214 |
|
10,035 |
9,219 |
$1.03M |
| 99204 |
|
6,098 |
5,664 |
$891K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
215,479 |
182,459 |
$771K |
| 99213 |
|
9,628 |
8,882 |
$766K |
| V2100 |
Lens spher single plano 4.00 |
116,416 |
106,565 |
$567K |
| 92015 |
|
233,865 |
229,039 |
$501K |
| 67028 |
|
1,435 |
1,146 |
$414K |
| G0467 |
Fqhc visit, estab pt |
1,366 |
1,246 |
$237K |
| 99233 |
Prolong inpt eval add15 m |
1,115 |
694 |
$187K |
| 92134 |
|
7,796 |
7,068 |
$143K |
| 92250 |
|
7,957 |
7,201 |
$140K |
| 99244 |
|
566 |
555 |
$131K |
| 99203 |
|
989 |
979 |
$117K |
| V2025 |
Eyeglasses delux frames |
2,288 |
2,022 |
$110K |
| V2784 |
Lens polycarb or equal |
69,257 |
68,263 |
$101K |
| 92340 |
|
16,727 |
16,417 |
$80K |
| 92060 |
|
27,230 |
24,784 |
$78K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
12,521 |
10,449 |
$75K |
| 66984 |
|
85 |
75 |
$73K |
| 92083 |
|
3,932 |
3,712 |
$64K |
| 99205 |
Prolong outpt/office vis |
464 |
427 |
$56K |
| 92273 |
|
589 |
585 |
$35K |
| 92235 |
|
501 |
498 |
$34K |
| 99254 |
|
109 |
101 |
$32K |
| J0178 |
Aflibercept injection |
36 |
25 |
$29K |
| 68761 |
|
1,039 |
362 |
$27K |
| 99223 |
Prolong inpt eval add15 m |
91 |
82 |
$23K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
5,326 |
4,593 |
$17K |
| 92133 |
|
2,738 |
2,612 |
$16K |
| V2200 |
Lens spher bifoc plano 4.00d |
2,629 |
2,422 |
$14K |
| S0516 |
Safety frames |
923 |
912 |
$12K |
| 92341 |
|
526 |
523 |
$12K |
| 92226 |
|
4,040 |
1,859 |
$11K |
| 99072 |
|
76 |
75 |
$10K |
| V2523 |
Cntct lens hydrophil extend |
323 |
295 |
$9K |
| 92201 |
|
1,982 |
1,300 |
$8K |
| 92202 |
|
3,555 |
3,272 |
$7K |
| 66821 |
|
38 |
29 |
$6K |
| 00142 |
|
55 |
52 |
$6K |
| V2750 |
Anti-reflective coating |
8,515 |
8,445 |
$6K |
| V2101 |
Single visn sphere 4.12-7.00 |
1,059 |
1,049 |
$5K |
| 2022F |
|
6,717 |
6,533 |
$5K |
| 99243 |
|
29 |
24 |
$5K |
| V2107 |
Spherocylinder 4.25d/12-2d |
1,714 |
1,491 |
$5K |
| 99215 |
Prolong outpt/office vis |
88 |
88 |
$4K |
| 99232 |
|
77 |
40 |
$3K |
| G0466 |
Fqhc visit new patient |
81 |
57 |
$3K |
| 95930 |
|
277 |
260 |
$3K |
| 99212 |
|
261 |
162 |
$2K |
| V2744 |
Tint photochromatic lens/es |
414 |
404 |
$2K |
| 92285 |
|
455 |
446 |
$2K |
| 1036F |
|
2,347 |
2,042 |
$2K |
| G8427 |
Docrev cur meds by elig clin |
2,924 |
2,510 |
$2K |
| V2520 |
Contact lens hydrophilic |
170 |
169 |
$1K |
| 76512 |
|
148 |
135 |
$1K |
| 2023F |
|
118 |
115 |
$975.96 |
| 92310 |
|
380 |
364 |
$913.78 |
| V2756 |
Eye glass case |
1,757 |
1,713 |
$814.34 |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
206 |
198 |
$684.62 |
| G8398 |
Dil macular/fundus not perfo |
664 |
655 |
$661.22 |
| 99221 |
|
12 |
12 |
$506.64 |
| 92002 |
|
15 |
15 |
$480.63 |
| 92082 |
|
34 |
34 |
$467.32 |
| 76514 |
|
196 |
192 |
$423.54 |
| G8397 |
Dil macula/fundus exam/w doc |
859 |
840 |
$393.68 |
| 92225 |
|
1,447 |
750 |
$376.72 |
| V2300 |
Lens sphere trifocal 4.00d |
42 |
41 |
$355.68 |
| G9905 |
No pt tbco scrn rng |
603 |
580 |
$304.45 |
| J7999 |
Compounded drug, noc |
229 |
206 |
$214.04 |
| G9903 |
Pt scrn tbco id as non user |
1,452 |
1,288 |
$190.22 |
| V2760 |
Scratch resistant coating |
911 |
901 |
$181.51 |
| 92136 |
|
18 |
12 |
$180.60 |
| V2201 |
Lens sphere bifocal 4.12-7.0 |
216 |
180 |
$162.00 |
| 92227 |
|
43 |
43 |
$143.59 |
| 83861 |
|
50 |
12 |
$142.34 |
| G8785 |
Bp scrn no perf at interval |
218 |
202 |
$96.08 |
| S9986 |
Not medically necessary svc |
758 |
710 |
$75.33 |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
121 |
115 |
$63.24 |
| G2104 |
Eye img valid w/7 stereo |
122 |
122 |
$42.16 |
| S9999 |
Sales tax |
70 |
69 |
$37.09 |
| 76519 |
|
12 |
12 |
$22.41 |
| 99024 |
|
16 |
12 |
$13.53 |
| G8428 |
Cur meds not document |
42 |
40 |
$2.68 |
| V2755 |
Uv lens/es |
668 |
656 |
$1.34 |
| 3072F |
|
47 |
47 |
$1.08 |
| 92020 |
|
301 |
298 |
$1.08 |
| 5010F |
|
631 |
585 |
$0.01 |
| V2799 |
Misc vision item or service |
118 |
76 |
$0.00 |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
1,473 |
807 |
$0.00 |
| V2781 |
Progressive lens per lens |
41 |
40 |
$0.00 |
| 2020F |
|
36 |
36 |
$0.00 |
| V2109 |
Spherocylinder 4.25d/4.25-6d |
18 |
18 |
$0.00 |
| V2308 |
Lens sphc trifocal 4.25-7/2. |
13 |
13 |
$0.00 |
| 2027F |
|
12 |
12 |
$0.00 |
| 2021F |
|
13 |
12 |
$0.00 |
| G8907 |
Pt doc no events on discharg |
17 |
12 |
$0.00 |
| V2106 |
Spherocylinder 4.00d/>6.00d |
34 |
34 |
$0.00 |
| 4040F |
|
13 |
12 |
$0.00 |
| G8918 |
Pt w/o preop order iv ab pro |
17 |
12 |
$0.00 |