| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
1,990 |
1,932 |
$118K |
| V2020 |
Vision svcs frames purchases |
3,175 |
3,099 |
$105K |
| V2784 |
Lens polycarb or equal |
1,771 |
1,643 |
$53K |
| 92004 |
|
633 |
623 |
$48K |
| 92015 |
|
3,245 |
3,126 |
$18K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
464 |
440 |
$11K |
| V2100 |
Lens spher single plano 4.00 |
398 |
394 |
$7K |
| 92250 |
|
129 |
117 |
$2K |
| V2781 |
Progressive lens per lens |
102 |
96 |
$1K |
| V2300 |
Lens sphere trifocal 4.00d |
13 |
13 |
$428.58 |
| 3072F |
|
24 |
24 |
$230.00 |
| G8427 |
Docrev cur meds by elig clin |
323 |
312 |
$0.00 |
| G8417 |
Calc bmi abv up param f/u |
82 |
81 |
$0.00 |
| G9744 |
Pt not eli d/t act dig htn |
39 |
39 |
$0.00 |
| G8752 |
Sys bp less 140 |
37 |
37 |
$0.00 |
| G8754 |
Dias bp less 90 |
37 |
37 |
$0.00 |
| 1036F |
|
62 |
62 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
49 |
49 |
$0.00 |