| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 68761 |
|
38,363 |
22,682 |
$926K |
| 92014 |
|
21,840 |
20,094 |
$834K |
| 92004 |
|
12,067 |
11,159 |
$786K |
| 92250 |
|
21,741 |
19,942 |
$330K |
| 92273 |
|
7,368 |
6,754 |
$282K |
| V2020 |
Vision svcs frames purchases |
3,187 |
2,923 |
$154K |
| V2784 |
Lens polycarb or equal |
1,339 |
1,203 |
$97K |
| V2750 |
Anti-reflective coating |
1,915 |
1,705 |
$70K |
| V2760 |
Scratch resistant coating |
3,899 |
3,549 |
$70K |
| V2100 |
Lens spher single plano 4.00 |
1,606 |
1,114 |
$58K |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
661 |
579 |
$58K |
| V2755 |
Uv lens/es |
3,886 |
3,550 |
$54K |
| 65205 |
|
3,782 |
3,241 |
$47K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,706 |
1,053 |
$47K |
| 92015 |
|
4,655 |
3,927 |
$43K |
| 92012 |
|
1,205 |
1,046 |
$27K |
| 76514 |
|
2,675 |
2,408 |
$9K |
| 92275 |
|
221 |
164 |
$7K |
| 92020 |
|
690 |
534 |
$3K |
| 92083 |
|
51 |
47 |
$1K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
113 |
80 |
$485.34 |
| 92285 |
|
41 |
39 |
$253.53 |
| 92202 |
|
26 |
24 |
$108.16 |
| V2200 |
Lens spher bifoc plano 4.00d |
17 |
14 |
$46.28 |
| G8785 |
Bp scrn no perf at interval |
50 |
43 |
$0.00 |
| 2022F |
|
47 |
41 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
45 |
38 |
$0.00 |
| G9905 |
No pt tbco scrn rng |
54 |
45 |
$0.00 |
| G9974 |
Mac exam perf |
16 |
16 |
$0.00 |
| 1036F |
|
1,106 |
988 |
$0.00 |
| 3072F |
|
17 |
15 |
$0.00 |
| G8428 |
Cur meds not document |
277 |
236 |
$0.00 |