| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological exa |
942 |
847 |
$35K |
| V2020 |
Vision svcs frames purchases |
1,843 |
1,644 |
$29K |
| S0620 |
Routine ophthalmological exa |
573 |
515 |
$21K |
| 92004 |
|
379 |
320 |
$20K |
| 92015 |
|
1,186 |
1,001 |
$15K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
841 |
762 |
$14K |
| 92014 |
|
356 |
298 |
$13K |
| 92340 |
|
470 |
350 |
$12K |
| V2100 |
Lens spher single plano 4.00 |
364 |
317 |
$5K |
| 92012 |
|
47 |
32 |
$2K |
| V2784 |
Lens polycarb or equal |
81 |
77 |
$820.12 |
| 92133 |
|
14 |
12 |
$273.88 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
14 |
13 |
$207.60 |
| G8427 |
Docrev cur meds by elig clin |
1,306 |
1,132 |
$46.18 |
| G9905 |
No pt tbco scrn rng |
843 |
723 |
$0.03 |
| G9903 |
Pt scrn tbco id as non user |
19 |
15 |
$0.00 |
| 1036F |
|
20 |
16 |
$0.00 |
| G9744 |
Pt not eli d/t act dig htn |
48 |
37 |
$0.00 |