| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
21,096 |
19,059 |
$1.02M |
| 92004 |
|
10,245 |
9,773 |
$745K |
| 66984 |
|
2,805 |
1,650 |
$521K |
| V2020 |
Vision svcs frames purchases |
11,651 |
11,118 |
$407K |
| V2784 |
Lens polycarb or equal |
4,546 |
3,759 |
$147K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,533 |
3,757 |
$140K |
| 92015 |
|
23,419 |
22,841 |
$114K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
2,563 |
1,417 |
$78K |
| 99213 |
|
1,989 |
1,693 |
$75K |
| 92340 |
|
9,461 |
9,431 |
$58K |
| 67028 |
|
920 |
735 |
$58K |
| 92134 |
|
4,372 |
3,602 |
$45K |
| 92136 |
|
2,356 |
1,656 |
$27K |
| V2100 |
Lens spher single plano 4.00 |
432 |
381 |
$15K |
| 92012 |
|
576 |
412 |
$9K |
| 92226 |
|
474 |
271 |
$2K |
| 92083 |
|
70 |
66 |
$2K |
| 92202 |
|
453 |
385 |
$2K |
| V2750 |
Anti-reflective coating |
144 |
67 |
$2K |
| 66821 |
|
23 |
12 |
$1K |
| 99212 |
|
14 |
12 |
$509.00 |
| V2744 |
Tint photochromatic lens/es |
17 |
17 |
$498.10 |
| 92225 |
|
51 |
28 |
$464.53 |
| 92250 |
|
28 |
27 |
$459.10 |
| V2025 |
Eyeglasses delux frames |
36 |
34 |
$388.80 |
| 99214 |
|
19 |
12 |
$236.22 |
| 92201 |
|
15 |
12 |
$71.69 |
| 1036F |
|
842 |
789 |
$0.00 |
| G8397 |
Dil macula/fundus exam/w doc |
15 |
15 |
$0.00 |
| G8482 |
Flu immunize order/admin |
586 |
534 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
1,616 |
1,515 |
$0.00 |
| G8783 |
Bp scrn perf rec interval |
562 |
525 |
$0.00 |
| 4040F |
|
1,204 |
1,133 |
$0.00 |
| 2026F |
|
14 |
14 |
$0.00 |
| G8484 |
Flu immunize no admin |
12 |
12 |
$0.00 |
| 4004F |
|
27 |
24 |
$0.00 |
| G9744 |
Pt not eli d/t act dig htn |
105 |
103 |
$0.00 |
| 2022F |
|
15 |
15 |
$0.00 |
| 5010F |
|
14 |
14 |
$0.00 |