| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
13,119 |
11,922 |
$769K |
| 92004 |
|
4,946 |
4,373 |
$353K |
| V2020 |
Vision svcs frames purchases |
13,063 |
11,591 |
$176K |
| 92012 |
|
4,177 |
3,580 |
$146K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
5,077 |
4,609 |
$114K |
| 99211 |
|
8,409 |
7,746 |
$101K |
| V2200 |
Lens spher bifoc plano 4.00d |
1,863 |
1,519 |
$98K |
| V2100 |
Lens spher single plano 4.00 |
4,392 |
3,962 |
$96K |
| 92015 |
|
14,655 |
12,841 |
$35K |
| 92340 |
|
3,102 |
2,831 |
$33K |
| 92250 |
|
1,496 |
1,248 |
$33K |
| V2781 |
Progressive lens per lens |
76 |
67 |
$8K |
| 99204 |
|
58 |
44 |
$4K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
104 |
96 |
$2K |
| V2799 |
Misc vision item or service |
230 |
211 |
$2K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
37 |
35 |
$2K |
| 92020 |
|
118 |
95 |
$1K |
| 92341 |
|
87 |
82 |
$933.61 |
| V2107 |
Spherocylinder 4.25d/12-2d |
14 |
12 |
$383.26 |
| V2101 |
Single visn sphere 4.12-7.00 |
13 |
12 |
$232.47 |
| 3072F |
|
43 |
37 |
$0.00 |
| G9902 |
Pt scrn tbco and id as user |
123 |
108 |
$0.00 |
| G8732 |
No doc of pain |
271 |
243 |
$0.00 |
| 1036F |
|
239 |
199 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
38 |
29 |
$0.00 |
| G8397 |
Dil macula/fundus exam/w doc |
16 |
14 |
$0.00 |
| G8783 |
Bp scrn perf rec interval |
368 |
319 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
491 |
387 |
$0.00 |
| 5010F |
|
16 |
14 |
$0.00 |