| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
14,775 |
13,692 |
$1.03M |
| 92004 |
|
7,567 |
7,053 |
$635K |
| V2020 |
Frames, purchases |
26,778 |
24,640 |
$402K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
18,682 |
16,828 |
$330K |
| 99211 |
|
22,683 |
20,991 |
$277K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
3,138 |
2,726 |
$148K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,758 |
4,397 |
$89K |
| 99213 |
|
1,189 |
998 |
$39K |
| 92250 |
|
1,274 |
1,052 |
$35K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,060 |
950 |
$30K |
| 92340 |
|
2,602 |
2,492 |
$30K |
| 92082 |
|
442 |
410 |
$15K |
| V2799 |
Vision item or service, miscellaneous |
820 |
786 |
$10K |
| 92133 |
|
476 |
424 |
$8K |
| V2781 |
Progressive lens, per lens |
96 |
91 |
$6K |
| 92341 |
|
286 |
283 |
$3K |
| 92015 |
|
15,884 |
14,291 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
88 |
81 |
$2K |
| 99212 |
|
43 |
37 |
$819.36 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
40 |
38 |
$717.83 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
70 |
69 |
$400.00 |
| 76514 |
|
53 |
52 |
$357.15 |
| 99214 |
|
16 |
14 |
$2.64 |
| 3072F |
|
200 |
177 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
17 |
16 |
$0.00 |