| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
1,134 |
1,103 |
$48K |
| 92004 |
|
1,076 |
1,053 |
$48K |
| 92015 |
|
2,423 |
2,349 |
$39K |
| 92340 |
|
1,275 |
1,230 |
$36K |
| V2020 |
Frames, purchases |
1,323 |
1,270 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
989 |
918 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
604 |
588 |
$6K |
| 92012 |
|
47 |
25 |
$2K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
15 |
14 |
$666.75 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
43 |
43 |
$497.64 |
| M1208 |
Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety |
12 |
12 |
$0.00 |
| G8785 |
Blood pressure reading not documented, reason not given |
13 |
13 |
$0.00 |