| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
6,495 |
6,084 |
$543K |
| 92014 |
|
3,437 |
3,228 |
$237K |
| V2781 |
Progressive lens per lens |
1,578 |
1,401 |
$180K |
| V2020 |
Vision svcs frames purchases |
10,813 |
9,770 |
$169K |
| V2760 |
Scratch resistant coating |
9,486 |
8,602 |
$135K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
6,160 |
5,644 |
$104K |
| 99211 |
|
4,317 |
4,070 |
$54K |
| 92340 |
|
5,778 |
5,140 |
$48K |
| V2100 |
Lens spher single plano 4.00 |
802 |
749 |
$14K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
543 |
504 |
$9K |
| V2799 |
Misc vision item or service |
651 |
598 |
$6K |
| 92342 |
|
423 |
405 |
$5K |
| V2107 |
Spherocylinder 4.25d/12-2d |
168 |
145 |
$3K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
47 |
30 |
$2K |
| 99213 |
|
19 |
16 |
$747.54 |
| 3072F |
|
129 |
81 |
$570.00 |
| 92250 |
|
33 |
28 |
$297.57 |
| V2784 |
Lens polycarb or equal |
202 |
177 |
$70.00 |
| V2756 |
Eye glass case |
202 |
175 |
$0.00 |
| 92015 |
|
10,363 |
9,374 |
$0.00 |