| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
3,952 |
3,622 |
$222K |
| 92004 |
|
1,733 |
1,581 |
$127K |
| 92340 |
|
5,066 |
4,630 |
$76K |
| 92015 |
|
6,420 |
5,861 |
$47K |
| V2750 |
Anti-reflective coating |
481 |
455 |
$40K |
| V2499 |
Variable asphericity lens |
1,367 |
1,255 |
$36K |
| V2410 |
Lens variab asphericity sing |
660 |
616 |
$18K |
| V2020 |
Vision svcs frames purchases |
1,567 |
1,439 |
$17K |
| V2755 |
Uv lens/es |
922 |
827 |
$16K |
| 99213 |
|
490 |
417 |
$14K |
| V2784 |
Lens polycarb or equal |
1,459 |
1,335 |
$11K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
706 |
646 |
$9K |
| V2100 |
Lens spher single plano 4.00 |
159 |
151 |
$2K |
| 92250 |
|
43 |
25 |
$748.84 |
| 99214 |
|
14 |
12 |
$324.66 |
| G8732 |
No doc of pain |
408 |
372 |
$0.00 |
| G8428 |
Cur meds not document |
227 |
204 |
$0.00 |
| G9366 |
1high risk no ord |
15 |
14 |
$0.00 |
| V2760 |
Scratch resistant coating |
71 |
71 |
$0.00 |
| G8785 |
Bp scrn no perf at interval |
163 |
143 |
$0.00 |
| G9368 |
>= 2 same hi-rsk med not ord |
56 |
53 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
68 |
63 |
$0.00 |