| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
1,860 |
1,792 |
$151K |
| 92014 |
|
2,338 |
2,287 |
$135K |
| 92250 |
|
3,209 |
3,099 |
$129K |
| 99213 |
|
2,006 |
1,914 |
$80K |
| 92083 |
|
1,603 |
1,525 |
$62K |
| 92340 |
|
3,648 |
3,541 |
$62K |
| V2410 |
Lens variab asphericity sing |
1,331 |
1,299 |
$49K |
| V2750 |
Anti-reflective coating |
662 |
649 |
$46K |
| V2499 |
Variable asphericity lens |
753 |
735 |
$37K |
| 92015 |
|
4,297 |
4,205 |
$35K |
| 99214 |
|
409 |
400 |
$30K |
| V2020 |
Vision svcs frames purchases |
2,345 |
2,279 |
$26K |
| 92133 |
|
1,040 |
1,022 |
$26K |
| V2784 |
Lens polycarb or equal |
2,351 |
2,284 |
$22K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,228 |
1,204 |
$19K |
| V2100 |
Lens spher single plano 4.00 |
573 |
565 |
$8K |
| V2755 |
Uv lens/es |
749 |
731 |
$3K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
60 |
60 |
$1K |
| 92273 |
|
14 |
14 |
$779.22 |
| 92012 |
|
155 |
143 |
$546.00 |
| V2200 |
Lens spher bifoc plano 4.00d |
30 |
30 |
$148.00 |
| 76514 |
|
13 |
12 |
$88.00 |
| 3285F |
|
30 |
30 |
$0.00 |
| G8428 |
Cur meds not document |
243 |
197 |
$0.00 |
| G8785 |
Bp scrn no perf at interval |
152 |
124 |
$0.00 |
| G9368 |
>= 2 same hi-rsk med not ord |
162 |
129 |
$0.00 |
| 0517F |
|
30 |
30 |
$0.00 |
| G9905 |
No pt tbco scrn rng |
12 |
12 |
$0.00 |
| G0029 |
No tob scr/cess int |
12 |
12 |
$0.00 |
| M1210 |
>=2 same meds tbl4 not ord |
113 |
81 |
$0.00 |