| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens polycarb or equal |
9,433 |
9,337 |
$816K |
| 92012 |
|
29,165 |
26,185 |
$724K |
| 92004 |
|
15,228 |
15,223 |
$644K |
| V2020 |
Vision svcs frames purchases |
24,679 |
24,658 |
$525K |
| 92014 |
|
10,396 |
10,393 |
$422K |
| 92340 |
|
15,673 |
15,658 |
$336K |
| 92015 |
|
37,475 |
37,432 |
$330K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
7,467 |
7,461 |
$249K |
| 92250 |
|
2,680 |
2,666 |
$97K |
| 99213 |
|
5,424 |
4,650 |
$74K |
| 92341 |
|
2,315 |
2,314 |
$73K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
2,095 |
2,091 |
$58K |
| 92002 |
|
990 |
990 |
$36K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
553 |
551 |
$24K |
| V2100 |
Lens spher single plano 4.00 |
646 |
643 |
$15K |
| 92134 |
|
764 |
763 |
$13K |
| V2107 |
Spherocylinder 4.25d/12-2d |
254 |
254 |
$8K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
139 |
137 |
$8K |
| 99212 |
|
643 |
559 |
$2K |
| 92202 |
|
38 |
38 |
$1K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
12 |
12 |
$377.06 |
| G8427 |
Docrev cur meds by elig clin |
2,193 |
1,759 |
$0.00 |
| G8785 |
Bp scrn no perf at interval |
2,136 |
1,718 |
$0.00 |
| G8421 |
Bmi not calculated |
941 |
831 |
$0.00 |
| G9905 |
No pt tbco scrn rng |
353 |
334 |
$0.00 |
| 5010F |
|
13 |
13 |
$0.00 |
| G9902 |
Pt scrn tbco and id as user |
33 |
33 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
1,988 |
1,599 |
$0.00 |
| G8422 |
Pt inelig bmi calculation |
311 |
280 |
$0.00 |
| G8732 |
No doc of pain |
149 |
122 |
$0.00 |
| G8428 |
Cur meds not document |
232 |
212 |
$0.00 |
| G8419 |
Calc bmi out nrm param nof/u |
19 |
18 |
$0.00 |
| M1220 |
Dre wth interp rtnopthy |
13 |
13 |
$0.00 |
| G8420 |
Calc bmi norm parameters |
26 |
26 |
$0.00 |