| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92341 |
|
1,179 |
1,136 |
$33K |
| 92012 |
|
801 |
665 |
$33K |
| 92015 |
|
1,321 |
1,272 |
$16K |
| V2020 |
Vision svcs frames purchases |
1,568 |
1,487 |
$14K |
| 92014 |
|
256 |
229 |
$13K |
| 99308 |
|
316 |
315 |
$12K |
| 1036F |
|
990 |
855 |
$6K |
| 92004 |
|
105 |
100 |
$6K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,045 |
828 |
$4K |
| 92340 |
|
125 |
122 |
$3K |
| 99309 |
|
57 |
56 |
$2K |
| 92342 |
|
305 |
305 |
$697.15 |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
61 |
54 |
$140.07 |
| V2200 |
Lens spher bifoc plano 4.00d |
171 |
142 |
$117.45 |
| G9905 |
No pt tbco scrn rng |
210 |
185 |
$0.00 |
| G8785 |
Bp scrn no perf at interval |
737 |
620 |
$0.00 |
| 2022F |
|
104 |
85 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
102 |
101 |
$0.00 |
| G0117 |
Glaucoma scrn hgh risk direc |
18 |
18 |
$0.00 |
| G9744 |
Pt not eli d/t act dig htn |
78 |
77 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
450 |
380 |
$0.00 |
| V2756 |
Eye glass case |
294 |
294 |
$0.00 |
| V2755 |
Uv lens/es |
615 |
588 |
$0.00 |
| 4177F |
|
16 |
16 |
$0.00 |