| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
9,767 |
9,448 |
$329K |
| 99213 |
|
5,611 |
5,154 |
$197K |
| 76513 |
|
2,526 |
1,739 |
$145K |
| 92134 |
|
2,860 |
2,614 |
$46K |
| 92133 |
|
2,003 |
1,919 |
$32K |
| V5130 |
In ear binaural hearing aid |
34 |
34 |
$28K |
| 92083 |
|
1,067 |
1,046 |
$23K |
| 99214 |
|
450 |
437 |
$21K |
| 66984 |
|
49 |
49 |
$18K |
| 92014 |
|
9,294 |
9,149 |
$17K |
| 65855 |
|
55 |
53 |
$16K |
| 92136 |
|
1,106 |
704 |
$16K |
| 92226 |
|
1,331 |
678 |
$15K |
| 92285 |
|
6,157 |
5,827 |
$13K |
| 92012 |
|
990 |
919 |
$10K |
| V5160 |
Dispensing fee binaural |
27 |
27 |
$9K |
| 92286 |
|
741 |
680 |
$6K |
| 76512 |
|
549 |
509 |
$6K |
| 92225 |
|
493 |
253 |
$5K |
| 76514 |
|
290 |
289 |
$3K |
| 92202 |
|
844 |
772 |
$3K |
| 92201 |
|
367 |
347 |
$2K |
| 66761 |
|
19 |
13 |
$2K |
| 0509T |
|
28 |
28 |
$1K |
| 92020 |
|
134 |
134 |
$738.84 |
| 92025 |
|
119 |
111 |
$663.02 |
| 92004 |
|
2,758 |
2,707 |
$579.24 |
| 92015 |
|
8,215 |
8,009 |
$461.00 |
| 92275 |
|
12 |
12 |
$328.00 |
| V2750 |
Anti-reflective coating |
1,810 |
871 |
$0.00 |
| V2020 |
Vision svcs frames purchases |
7,197 |
6,985 |
$0.00 |
| G8785 |
Bp scrn no perf at interval |
14 |
14 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
53 |
53 |
$0.00 |
| V2200 |
Lens spher bifoc plano 4.00d |
1,764 |
866 |
$0.00 |
| V2784 |
Lens polycarb or equal |
6,215 |
3,020 |
$0.00 |
| G8397 |
Dil macula/fundus exam/w doc |
715 |
709 |
$0.00 |
| V2781 |
Progressive lens per lens |
626 |
302 |
$0.00 |
| V2100 |
Lens spher single plano 4.00 |
10,281 |
5,001 |
$0.00 |
| V2744 |
Tint photochromatic lens/es |
1,008 |
491 |
$0.00 |
| V2299 |
Lens bifocal speciality |
598 |
293 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
38 |
37 |
$0.00 |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
126 |
62 |
$0.00 |
| 1036F |
|
38 |
37 |
$0.00 |