| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
4,993 |
4,481 |
$357K |
| 92014 |
|
4,210 |
3,716 |
$254K |
| V2020 |
Vision svcs frames purchases |
6,697 |
6,291 |
$89K |
| 92012 |
|
896 |
669 |
$43K |
| 92060 |
|
1,372 |
1,212 |
$42K |
| 99213 |
|
646 |
584 |
$28K |
| 92250 |
|
3,176 |
2,519 |
$24K |
| 92015 |
|
6,881 |
5,749 |
$23K |
| 92340 |
|
1,867 |
1,751 |
$22K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,143 |
3,243 |
$18K |
| 76512 |
|
1,488 |
1,205 |
$13K |
| 92100 |
|
81 |
65 |
$13K |
| 92341 |
|
763 |
714 |
$10K |
| 92285 |
|
3,048 |
2,344 |
$10K |
| 92286 |
|
1,660 |
1,262 |
$10K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,013 |
751 |
$6K |
| V2100 |
Lens spher single plano 4.00 |
1,798 |
1,425 |
$6K |
| 92025 |
|
931 |
731 |
$6K |
| 92083 |
|
284 |
240 |
$6K |
| 92273 |
|
121 |
98 |
$4K |
| 76514 |
|
1,280 |
1,052 |
$3K |
| 92133 |
|
142 |
124 |
$956.49 |
| V2200 |
Lens spher bifoc plano 4.00d |
137 |
124 |
$822.00 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
95 |
64 |
$792.21 |
| 92201 |
|
136 |
108 |
$534.24 |
| V2107 |
Spherocylinder 4.25d/12-2d |
32 |
27 |
$190.90 |
| V2755 |
Uv lens/es |
36 |
36 |
$180.00 |
| V2025 |
Eyeglasses delux frames |
170 |
153 |
$110.00 |
| 92283 |
|
2,788 |
2,154 |
$81.00 |
| 92342 |
|
707 |
706 |
$79.87 |
| V2745 |
Tint, any color/solid/grad |
15 |
15 |
$45.00 |
| 92310 |
|
16 |
14 |
$35.00 |
| V2756 |
Eye glass case |
704 |
703 |
$0.00 |
| 92020 |
|
67 |
51 |
$0.00 |
| G0117 |
Glaucoma scrn hgh risk direc |
1,241 |
1,241 |
$0.00 |
| 2022F |
|
1,244 |
1,239 |
$0.00 |