| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
29,763 |
29,663 |
$1.35M |
| 92014 |
|
18,407 |
18,359 |
$1.05M |
| 92004 |
|
14,450 |
14,428 |
$1.03M |
| 92012 |
|
23,069 |
21,497 |
$900K |
| 68761 |
|
10,369 |
6,428 |
$808K |
| 92083 |
|
13,791 |
13,720 |
$657K |
| V2100 |
Lens spher single plano 4.00 |
18,735 |
10,821 |
$287K |
| V2020 |
Vision svcs frames purchases |
19,181 |
18,997 |
$235K |
| 92285 |
|
7,832 |
7,461 |
$176K |
| 92133 |
|
3,617 |
3,607 |
$104K |
| 76512 |
|
1,167 |
769 |
$82K |
| 92015 |
|
5,821 |
5,821 |
$71K |
| 92060 |
|
1,823 |
1,822 |
$64K |
| 92286 |
|
733 |
731 |
$60K |
| V2200 |
Lens spher bifoc plano 4.00d |
2,095 |
1,206 |
$49K |
| 92340 |
|
3,334 |
3,334 |
$45K |
| 92202 |
|
2,314 |
2,018 |
$40K |
| 92225 |
|
2,127 |
1,456 |
$39K |
| 92226 |
|
1,964 |
1,414 |
$33K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,253 |
3,266 |
$33K |
| 92201 |
|
1,939 |
1,773 |
$29K |
| V2784 |
Lens polycarb or equal |
10,456 |
5,643 |
$27K |
| 92020 |
|
2,013 |
2,011 |
$27K |
| S0580 |
Polycarb lens |
1,493 |
1,490 |
$25K |
| 92025 |
|
826 |
826 |
$17K |
| 92134 |
|
506 |
504 |
$14K |
| 99203 |
|
194 |
194 |
$12K |
| 99213 |
|
283 |
283 |
$11K |
| 99212 |
|
289 |
271 |
$6K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
190 |
136 |
$3K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
247 |
202 |
$2K |
| 92341 |
|
40 |
40 |
$686.34 |
| 92132 |
|
28 |
28 |
$619.50 |
| 76514 |
|
61 |
61 |
$464.94 |
| V2107 |
Spherocylinder 4.25d/12-2d |
15 |
14 |
$136.80 |
| 1036F |
|
195 |
180 |
$0.00 |
| V2755 |
Uv lens/es |
2,166 |
1,080 |
$0.00 |
| G8397 |
Dil macula/fundus exam/w doc |
46 |
43 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
412 |
383 |
$0.00 |
| 0517F |
|
12 |
12 |
$0.00 |
| 5010F |
|
13 |
13 |
$0.00 |