| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
4,936 |
4,821 |
$322K |
| V2750 |
Anti-reflective coating |
2,407 |
2,345 |
$226K |
| 92004 |
|
2,343 |
2,285 |
$201K |
| 92340 |
|
6,570 |
6,361 |
$113K |
| V2020 |
Vision svcs frames purchases |
6,664 |
6,495 |
$90K |
| V2784 |
Lens polycarb or equal |
6,691 |
6,513 |
$89K |
| 92015 |
|
7,347 |
7,168 |
$62K |
| V2499 |
Variable asphericity lens |
1,625 |
850 |
$59K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
6,270 |
3,599 |
$33K |
| V2100 |
Lens spher single plano 4.00 |
1,843 |
1,241 |
$8K |
| V2107 |
Spherocylinder 4.25d/12-2d |
168 |
110 |
$1K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
176 |
119 |
$1K |
| 99213 |
|
17 |
15 |
$630.00 |
| G8427 |
Docrev cur meds by elig clin |
60 |
54 |
$0.00 |
| G8731 |
Pain neg no plan |
74 |
68 |
$0.00 |
| G8783 |
Bp scrn perf rec interval |
58 |
52 |
$0.00 |
| G8785 |
Bp scrn no perf at interval |
13 |
13 |
$0.00 |
| 1036F |
|
72 |
66 |
$0.00 |