| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
1,666 |
1,589 |
$109K |
| 92004 |
|
866 |
817 |
$75K |
| V2020 |
Vision svcs frames purchases |
2,151 |
2,069 |
$62K |
| 92340 |
|
2,142 |
2,066 |
$62K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,547 |
1,495 |
$26K |
| V2784 |
Lens polycarb or equal |
1,703 |
1,643 |
$13K |
| V2100 |
Lens spher single plano 4.00 |
341 |
323 |
$5K |
| V2760 |
Scratch resistant coating |
1,701 |
1,641 |
$3K |
| 99213 |
|
16 |
14 |
$682.08 |
| V2107 |
Spherocylinder 4.25d/12-2d |
13 |
13 |
$197.56 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
12 |
12 |
$190.00 |
| G8427 |
Docrev cur meds by elig clin |
1,492 |
1,380 |
$0.00 |
| G8785 |
Bp scrn no perf at interval |
306 |
271 |
$0.00 |
| G9905 |
No pt tbco scrn rng |
447 |
424 |
$0.00 |
| 99199 |
|
59 |
54 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
638 |
566 |
$0.00 |
| 1036F |
|
1,578 |
1,466 |
$0.00 |