| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
1,866 |
1,800 |
$159K |
| 92014 |
|
1,911 |
1,874 |
$124K |
| V2020 |
Vision svcs frames purchases |
2,437 |
2,393 |
$70K |
| 92340 |
|
1,892 |
1,871 |
$53K |
| 92015 |
|
4,453 |
4,326 |
$38K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,562 |
1,546 |
$28K |
| V2784 |
Lens polycarb or equal |
2,232 |
2,195 |
$23K |
| V2760 |
Scratch resistant coating |
2,193 |
2,157 |
$14K |
| 99213 |
|
157 |
141 |
$6K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
192 |
191 |
$4K |
| 92341 |
|
98 |
98 |
$3K |
| 92370 |
|
121 |
119 |
$3K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
232 |
225 |
$3K |
| V2100 |
Lens spher single plano 4.00 |
130 |
126 |
$2K |
| 99203 |
|
13 |
12 |
$948.48 |
| V2499 |
Variable asphericity lens |
36 |
34 |
$835.00 |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
12 |
12 |
$430.28 |
| V2107 |
Spherocylinder 4.25d/12-2d |
12 |
12 |
$198.18 |
| G9903 |
Pt scrn tbco id as non user |
3,532 |
3,354 |
$0.00 |
| 1036F |
|
3,554 |
3,372 |
$0.00 |
| 2023F |
|
102 |
95 |
$0.00 |
| G9906 |
Pt recv tbco cess interv |
339 |
325 |
$0.00 |
| G8952 |
Pre-htn/htn, no f/u, not gvn |
484 |
458 |
$0.00 |
| G9902 |
Pt scrn tbco and id as user |
439 |
422 |
$0.00 |
| 3072F |
|
14 |
13 |
$0.00 |
| G8397 |
Dil macula/fundus exam/w doc |
12 |
12 |
$0.00 |
| G8783 |
Bp scrn perf rec interval |
395 |
387 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
456 |
416 |
$0.00 |
| G9905 |
No pt tbco scrn rng |
326 |
323 |
$0.00 |
| G8785 |
Bp scrn no perf at interval |
246 |
237 |
$0.00 |
| G9744 |
Pt not eli d/t act dig htn |
27 |
27 |
$0.00 |
| 99199 |
|
12 |
12 |
$0.00 |