| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens polycarb or equal |
33,376 |
17,987 |
$1.08M |
| 92014 |
|
15,120 |
14,766 |
$633K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
13,041 |
5,711 |
$580K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
20,964 |
12,332 |
$399K |
| 92012 |
|
10,697 |
10,402 |
$309K |
| 92004 |
|
4,001 |
3,930 |
$232K |
| 92015 |
|
32,676 |
31,931 |
$186K |
| V2020 |
Vision svcs frames purchases |
26,519 |
25,056 |
$184K |
| J0178 |
Aflibercept injection |
1,560 |
1,365 |
$179K |
| 67028 |
|
2,571 |
2,280 |
$145K |
| V2100 |
Lens spher single plano 4.00 |
5,491 |
3,416 |
$87K |
| 92134 |
|
4,263 |
3,935 |
$80K |
| 99214 |
|
1,217 |
1,078 |
$49K |
| V2025 |
Eyeglasses delux frames |
252 |
218 |
$23K |
| 92002 |
|
773 |
763 |
$21K |
| 66984 |
|
69 |
65 |
$18K |
| 99213 |
|
681 |
654 |
$14K |
| 92083 |
|
279 |
240 |
$12K |
| 99204 |
|
102 |
98 |
$8K |
| 92250 |
|
200 |
189 |
$8K |
| 92133 |
|
307 |
276 |
$8K |
| V2750 |
Anti-reflective coating |
115 |
91 |
$7K |
| 92285 |
|
463 |
445 |
$5K |
| 92020 |
|
560 |
550 |
$5K |
| S0621 |
Routine ophthalmological exa |
131 |
130 |
$4K |
| 99203 |
|
96 |
91 |
$4K |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
84 |
41 |
$3K |
| 99212 |
|
102 |
98 |
$2K |
| J9035 |
Bevacizumab injection |
651 |
536 |
$2K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
59 |
39 |
$1K |
| V2755 |
Uv lens/es |
59 |
29 |
$880.00 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
40 |
28 |
$700.00 |
| S0620 |
Routine ophthalmological exa |
20 |
20 |
$600.00 |
| V2107 |
Spherocylinder 4.25d/12-2d |
18 |
12 |
$360.00 |
| 92136 |
|
13 |
12 |
$201.03 |
| 76519 |
|
14 |
12 |
$195.40 |
| J2777 |
Inj, faricimab-svoa, 0.1mg |
26 |
25 |
$0.00 |
| J7999 |
Compounded drug, noc |
115 |
103 |
$0.00 |