| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
3,084 |
3,081 |
$109K |
| 92014 |
|
2,599 |
2,599 |
$89K |
| 92250 |
|
1,987 |
1,985 |
$51K |
| 92083 |
|
1,698 |
1,694 |
$42K |
| 92004 |
|
545 |
545 |
$30K |
| 92132 |
|
1,578 |
1,577 |
$23K |
| 92340 |
|
1,462 |
1,458 |
$20K |
| V2100 |
Lens spher single plano 4.00 |
840 |
485 |
$17K |
| S0580 |
Polycarb lens |
851 |
851 |
$16K |
| 83861 |
|
2,681 |
1,344 |
$12K |
| 92286 |
|
933 |
933 |
$9K |
| 92133 |
|
525 |
525 |
$8K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
641 |
627 |
$6K |
| 92202 |
|
755 |
750 |
$5K |
| 92273 |
|
368 |
368 |
$4K |
| 92285 |
|
313 |
309 |
$3K |
| 92145 |
|
381 |
381 |
$2K |
| 92226 |
|
476 |
403 |
$2K |
| 76512 |
|
119 |
90 |
$2K |
| 76514 |
|
287 |
287 |
$473.04 |
| 92020 |
|
39 |
39 |
$344.17 |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
13 |
12 |
$333.14 |
| 92341 |
|
13 |
13 |
$278.00 |
| V2784 |
Lens polycarb or equal |
186 |
93 |
$260.00 |
| 1036F |
|
1,793 |
1,783 |
$243.81 |
| G9903 |
Pt scrn tbco id as non user |
1,154 |
1,145 |
$225.46 |
| G9744 |
Pt not eli d/t act dig htn |
814 |
814 |
$191.71 |
| 92134 |
|
32 |
32 |
$147.65 |
| G8754 |
Dias bp less 90 |
313 |
313 |
$109.20 |
| 5010F |
|
99 |
99 |
$91.52 |
| 4177F |
|
59 |
59 |
$78.07 |
| G8397 |
Dil macula/fundus exam/w doc |
98 |
98 |
$74.03 |
| G8785 |
Bp scrn no perf at interval |
159 |
155 |
$67.71 |
| G8752 |
Sys bp less 140 |
221 |
221 |
$61.14 |
| G8427 |
Docrev cur meds by elig clin |
681 |
681 |
$0.00 |
| G9905 |
No pt tbco scrn rng |
381 |
380 |
$0.00 |
| 2026F |
|
25 |
25 |
$0.00 |
| G8952 |
Pre-htn/htn, no f/u, not gvn |
193 |
192 |
$0.00 |