| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
4,079 |
3,946 |
$270K |
| 92004 |
|
2,759 |
2,669 |
$246K |
| V2020 |
Vision svcs frames purchases |
6,868 |
6,388 |
$178K |
| 92340 |
|
5,290 |
5,178 |
$158K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,849 |
4,543 |
$79K |
| V2784 |
Lens polycarb or equal |
5,594 |
5,189 |
$44K |
| 92015 |
|
6,014 |
5,836 |
$13K |
| V2760 |
Scratch resistant coating |
4,650 |
4,521 |
$9K |
| 99213 |
|
251 |
192 |
$9K |
| 92370 |
|
326 |
308 |
$9K |
| V2100 |
Lens spher single plano 4.00 |
583 |
543 |
$8K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
398 |
343 |
$7K |
| 92341 |
|
191 |
190 |
$6K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
203 |
188 |
$3K |
| S0516 |
Safety frames |
56 |
55 |
$894.88 |
| S0504 |
Singl prscrp lens |
63 |
62 |
$580.14 |
| V2107 |
Spherocylinder 4.25d/12-2d |
38 |
38 |
$567.19 |
| V2499 |
Variable asphericity lens |
16 |
15 |
$443.00 |
| S9999 |
Sales tax |
96 |
95 |
$162.48 |
| 4004F |
|
217 |
207 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
1,952 |
1,838 |
$0.00 |
| 99199 |
|
125 |
122 |
$0.00 |
| G8783 |
Bp scrn perf rec interval |
538 |
512 |
$0.00 |
| G9905 |
No pt tbco scrn rng |
249 |
244 |
$0.00 |
| G8785 |
Bp scrn no perf at interval |
75 |
73 |
$0.00 |
| 2026F |
|
51 |
51 |
$0.00 |
| G9744 |
Pt not eli d/t act dig htn |
37 |
36 |
$0.00 |
| 2022F |
|
16 |
15 |
$0.00 |
| G2102 |
Dil retinal eye exam |
12 |
12 |
$0.00 |
| G2104 |
Eye img valid w/7 stereo |
35 |
34 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
2,857 |
2,720 |
$0.00 |
| G8952 |
Pre-htn/htn, no f/u, not gvn |
658 |
615 |
$0.00 |
| G9906 |
Pt recv tbco cess interv |
372 |
359 |
$0.00 |
| 1036F |
|
3,635 |
3,447 |
$0.00 |
| G9902 |
Pt scrn tbco and id as user |
437 |
421 |
$0.00 |
| G8397 |
Dil macula/fundus exam/w doc |
14 |
13 |
$0.00 |