| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
5,368 |
5,079 |
$339K |
| 92004 |
|
3,329 |
3,089 |
$263K |
| 92340 |
|
8,102 |
7,547 |
$132K |
| V2499 |
Variable asphericity lens |
2,219 |
2,002 |
$116K |
| 92015 |
|
9,217 |
8,645 |
$75K |
| V2020 |
Vision svcs frames purchases |
2,430 |
2,206 |
$41K |
| 99213 |
|
1,008 |
911 |
$35K |
| 92250 |
|
815 |
753 |
$24K |
| 92273 |
|
186 |
166 |
$9K |
| V2410 |
Lens variab asphericity sing |
340 |
181 |
$9K |
| 92083 |
|
291 |
272 |
$9K |
| 92341 |
|
513 |
477 |
$8K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
382 |
361 |
$7K |
| 92370 |
|
1,328 |
1,237 |
$6K |
| 99212 |
|
270 |
254 |
$5K |
| V2100 |
Lens spher single plano 4.00 |
275 |
202 |
$4K |
| 92133 |
|
190 |
174 |
$3K |
| V2784 |
Lens polycarb or equal |
505 |
404 |
$2K |
| 92285 |
|
57 |
55 |
$2K |
| 99203 |
|
15 |
14 |
$1K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
36 |
32 |
$812.00 |
| 99214 |
|
20 |
14 |
$576.88 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
32 |
31 |
$569.43 |
| S0620 |
Routine ophthalmological exa |
13 |
13 |
$495.00 |
| S0621 |
Routine ophthalmological exa |
17 |
13 |
$332.00 |
| V2107 |
Spherocylinder 4.25d/12-2d |
16 |
16 |
$319.68 |
| V2750 |
Anti-reflective coating |
172 |
169 |
$0.00 |
| V2025 |
Eyeglasses delux frames |
18 |
18 |
$0.00 |