| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
10,894 |
9,192 |
$803K |
| 92004 |
|
4,361 |
3,875 |
$409K |
| 92015 |
|
17,592 |
14,496 |
$392K |
| 92340 |
|
16,619 |
13,550 |
$300K |
| V2020 |
Vision svcs frames purchases |
11,677 |
10,439 |
$270K |
| V2100 |
Lens spher single plano 4.00 |
6,080 |
5,600 |
$149K |
| V2784 |
Lens polycarb or equal |
4,112 |
3,820 |
$69K |
| V2410 |
Lens variab asphericity sing |
1,052 |
1,024 |
$62K |
| 92012 |
|
644 |
333 |
$22K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,017 |
567 |
$15K |
| 92002 |
|
246 |
129 |
$8K |
| V2200 |
Lens spher bifoc plano 4.00d |
53 |
37 |
$1K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
15 |
14 |
$376.53 |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
32 |
12 |
$345.24 |
| 1036F |
|
554 |
540 |
$127.89 |
| 3072F |
|
969 |
865 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
372 |
363 |
$0.00 |
| G8428 |
Cur meds not document |
14 |
12 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
925 |
877 |
$0.00 |
| G9744 |
Pt not eli d/t act dig htn |
85 |
84 |
$0.00 |
| G8783 |
Bp scrn perf rec interval |
15 |
15 |
$0.00 |