| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
10,396 |
9,868 |
$1.01M |
| 92014 |
|
11,450 |
10,510 |
$945K |
| 99214 |
|
10,579 |
9,906 |
$727K |
| V2020 |
Vision svcs frames purchases |
11,012 |
10,861 |
$563K |
| 92015 |
|
29,943 |
28,075 |
$432K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
6,347 |
5,693 |
$305K |
| 92250 |
|
8,932 |
8,192 |
$230K |
| 99213 |
|
4,069 |
3,550 |
$212K |
| V2100 |
Lens spher single plano 4.00 |
2,690 |
2,545 |
$80K |
| 99204 |
|
617 |
578 |
$61K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
554 |
549 |
$42K |
| 92083 |
|
655 |
620 |
$26K |
| V2784 |
Lens polycarb or equal |
4,850 |
4,689 |
$21K |
| 83861 |
|
1,461 |
770 |
$20K |
| 92133 |
|
606 |
575 |
$16K |
| 92082 |
|
430 |
411 |
$15K |
| 99203 |
|
181 |
172 |
$13K |
| 92340 |
|
409 |
408 |
$8K |
| 92134 |
|
149 |
135 |
$3K |
| 92012 |
|
50 |
40 |
$3K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
38 |
38 |
$2K |
| 99072 |
|
2,496 |
2,230 |
$1K |
| V2750 |
Anti-reflective coating |
479 |
467 |
$1K |
| 76514 |
|
109 |
100 |
$947.13 |
| V2025 |
Eyeglasses delux frames |
17 |
17 |
$906.84 |
| V2107 |
Spherocylinder 4.25d/12-2d |
12 |
12 |
$685.00 |
| V2755 |
Uv lens/es |
689 |
678 |
$363.40 |
| V2744 |
Tint photochromatic lens/es |
249 |
243 |
$296.44 |
| V2760 |
Scratch resistant coating |
13 |
13 |
$140.00 |
| V2781 |
Progressive lens per lens |
15 |
15 |
$26.59 |
| G8732 |
No doc of pain |
998 |
646 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
340 |
223 |
$0.00 |
| G8754 |
Dias bp less 90 |
234 |
139 |
$0.00 |
| 1036F |
|
67 |
45 |
$0.00 |
| G9366 |
1high risk no ord |
30 |
24 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
1,767 |
1,122 |
$0.00 |
| G8783 |
Bp scrn perf rec interval |
39 |
24 |
$0.00 |
| G8752 |
Sys bp less 140 |
197 |
122 |
$0.00 |
| G9368 |
>= 2 same hi-rsk med not ord |
30 |
24 |
$0.00 |