| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
275,804 |
245,968 |
$19.26M |
| 92014 |
|
316,679 |
277,653 |
$16.61M |
| V2100 |
Lens spher single plano 4.00 |
296,473 |
246,941 |
$14.86M |
| V2025 |
Eyeglasses delux frames |
217,274 |
185,480 |
$10.11M |
| V2020 |
Vision svcs frames purchases |
271,730 |
235,278 |
$8.57M |
| V2200 |
Lens spher bifoc plano 4.00d |
25,900 |
23,582 |
$1.93M |
| V2799 |
Misc vision item or service |
86,882 |
52,309 |
$1.74M |
| 92012 |
|
24,486 |
20,625 |
$1.51M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
55,379 |
42,072 |
$936K |
| 99204 |
|
7,306 |
6,504 |
$929K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
7,822 |
6,697 |
$384K |
| V2784 |
Lens polycarb or equal |
65,911 |
56,174 |
$371K |
| 92015 |
|
264,978 |
229,506 |
$307K |
| 92060 |
|
14,749 |
12,969 |
$277K |
| 99213 |
|
5,822 |
5,248 |
$264K |
| 99214 |
|
3,814 |
3,355 |
$252K |
| 92340 |
|
69,175 |
61,537 |
$168K |
| 67028 |
|
1,950 |
1,536 |
$155K |
| 99244 |
|
594 |
508 |
$113K |
| 92250 |
|
18,364 |
17,343 |
$110K |
| 92083 |
|
5,971 |
5,418 |
$108K |
| V2101 |
Single visn sphere 4.12-7.00 |
1,512 |
1,345 |
$86K |
| 99243 |
|
619 |
605 |
$81K |
| 92134 |
|
7,678 |
6,879 |
$81K |
| 92283 |
|
7,474 |
7,294 |
$79K |
| 92273 |
|
729 |
704 |
$77K |
| 76512 |
|
5,801 |
4,251 |
$74K |
| 99203 |
|
558 |
509 |
$59K |
| V2599 |
Contact lens/es other type |
594 |
482 |
$54K |
| 92341 |
|
9,906 |
9,193 |
$49K |
| 92235 |
|
720 |
680 |
$49K |
| V2201 |
Lens sphere bifocal 4.12-7.0 |
620 |
562 |
$47K |
| S0516 |
Safety frames |
280 |
210 |
$47K |
| V2750 |
Anti-reflective coating |
24,461 |
20,397 |
$44K |
| 99233 |
Prolong inpt eval add15 m |
290 |
179 |
$44K |
| 66984 |
|
150 |
122 |
$41K |
| V2781 |
Progressive lens per lens |
234 |
223 |
$39K |
| 92100 |
|
412 |
395 |
$36K |
| 92133 |
|
3,722 |
3,467 |
$27K |
| 92285 |
|
8,033 |
7,801 |
$27K |
| V2744 |
Tint photochromatic lens/es |
998 |
916 |
$26K |
| 99232 |
|
336 |
176 |
$18K |
| 92025 |
|
2,567 |
2,511 |
$16K |
| 92286 |
|
3,092 |
3,031 |
$15K |
| V2520 |
Contact lens hydrophilic |
233 |
203 |
$14K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
2,234 |
1,606 |
$12K |
| V2745 |
Tint, any color/solid/grad |
314 |
299 |
$10K |
| V2303 |
Lens sphcy trifocal 4.0/.12- |
54 |
53 |
$9K |
| 92201 |
|
3,350 |
2,695 |
$8K |
| 92310 |
|
3,094 |
2,726 |
$8K |
| V2502 |
Contact lens pmma bifocal |
172 |
113 |
$8K |
| 92136 |
|
165 |
129 |
$8K |
| 92228 |
|
2,233 |
2,192 |
$7K |
| 92002 |
|
35 |
35 |
$6K |
| V2300 |
Lens sphere trifocal 4.00d |
69 |
58 |
$6K |
| 66761 |
|
34 |
30 |
$6K |
| 92227 |
|
1,193 |
1,067 |
$5K |
| J9035 |
Bevacizumab injection |
96 |
63 |
$5K |
| S0595 |
New lenses in pts old frame |
758 |
700 |
$4K |
| 76514 |
|
2,694 |
2,543 |
$4K |
| 92342 |
|
300 |
295 |
$4K |
| 99212 |
|
138 |
135 |
$3K |
| V2755 |
Uv lens/es |
2,398 |
1,784 |
$3K |
| V2521 |
Cntct lens hydrophilic toric |
44 |
44 |
$3K |
| 99223 |
Prolong inpt eval add15 m |
13 |
12 |
$3K |
| 2022F |
|
2,122 |
1,916 |
$2K |
| 92020 |
|
1,237 |
1,108 |
$2K |
| 92202 |
|
1,101 |
1,000 |
$2K |
| V2522 |
Cntct lens hydrophil bifocl |
45 |
44 |
$2K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
20 |
13 |
$2K |
| J3490 |
Drugs unclassified injection |
205 |
127 |
$2K |
| G0117 |
Glaucoma scrn hgh risk direc |
57 |
41 |
$1K |
| V2762 |
Polarization, any lens |
30 |
13 |
$1K |
| V2107 |
Spherocylinder 4.25d/12-2d |
468 |
315 |
$1K |
| 76519 |
|
47 |
28 |
$671.70 |
| V2760 |
Scratch resistant coating |
1,282 |
449 |
$610.00 |
| 1036F |
|
281 |
254 |
$164.98 |
| 99205 |
Prolong outpt/office vis |
12 |
12 |
$156.42 |
| 4040F |
|
624 |
494 |
$126.28 |
| 92226 |
|
385 |
216 |
$36.26 |
| 1159F |
|
569 |
497 |
$35.00 |
| G8428 |
Cur meds not document |
107 |
100 |
$22.76 |
| G8427 |
Docrev cur meds by elig clin |
833 |
652 |
$8.47 |
| 1000F |
|
921 |
881 |
$7.70 |
| 5010F |
|
2,129 |
1,932 |
$4.62 |
| 2020F |
|
2,861 |
2,451 |
$4.62 |
| 99024 |
|
1,582 |
1,045 |
$2.31 |
| 2023F |
|
272 |
260 |
$1.54 |
| 1160F |
|
569 |
497 |
$0.00 |
| G8482 |
Flu immunize order/admin |
702 |
548 |
$0.00 |
| 92225 |
|
422 |
230 |
$0.00 |
| 99072 |
|
728 |
695 |
$0.00 |
| G8785 |
Bp scrn no perf at interval |
84 |
71 |
$0.00 |
| G9905 |
No pt tbco scrn rng |
40 |
33 |
$0.00 |
| 2025F |
|
12 |
12 |
$0.00 |
| G8397 |
Dil macula/fundus exam/w doc |
2,414 |
2,284 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
934 |
750 |
$0.00 |
| 1157F |
|
63 |
39 |
$0.00 |
| J7999 |
Compounded drug, noc |
96 |
76 |
$0.00 |
| G9902 |
Pt scrn tbco and id as user |
33 |
28 |
$0.00 |
| 3072F |
|
107 |
102 |
$0.00 |
| G9908 |
No pt tbco cess interv rng |
47 |
42 |
$0.00 |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
24 |
24 |
$0.00 |