| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
7,617 |
7,579 |
$404K |
| 92014 |
|
6,262 |
6,239 |
$360K |
| 92004 |
|
3,328 |
3,310 |
$230K |
| 76513 |
|
1,903 |
1,882 |
$201K |
| V2020 |
Vision svcs frames purchases |
12,335 |
12,231 |
$142K |
| 92012 |
|
3,478 |
3,378 |
$136K |
| 92340 |
|
9,508 |
9,398 |
$127K |
| 92083 |
|
2,472 |
2,457 |
$125K |
| 92015 |
|
8,412 |
8,366 |
$104K |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
1,289 |
1,272 |
$76K |
| 92133 |
|
1,953 |
1,945 |
$57K |
| V2100 |
Lens spher single plano 4.00 |
5,079 |
5,031 |
$57K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
5,306 |
5,244 |
$44K |
| 92341 |
|
1,852 |
1,833 |
$32K |
| S0580 |
Polycarb lens |
1,629 |
1,619 |
$25K |
| 92283 |
|
707 |
707 |
$23K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,190 |
1,180 |
$20K |
| V2200 |
Lens spher bifoc plano 4.00d |
1,062 |
1,050 |
$19K |
| 92285 |
|
960 |
948 |
$14K |
| 92226 |
|
542 |
474 |
$13K |
| 92134 |
|
370 |
370 |
$11K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
1,204 |
1,187 |
$10K |
| 92202 |
|
1,043 |
1,039 |
$9K |
| V2784 |
Lens polycarb or equal |
407 |
405 |
$9K |
| 99213 |
|
170 |
164 |
$6K |
| 92145 |
|
567 |
566 |
$5K |
| 76514 |
|
376 |
375 |
$3K |
| 68761 |
|
25 |
24 |
$3K |
| 92225 |
|
107 |
102 |
$3K |
| V2107 |
Spherocylinder 4.25d/12-2d |
186 |
183 |
$2K |
| 92060 |
|
29 |
29 |
$1K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
12 |
12 |
$162.00 |
| V2025 |
Eyeglasses delux frames |
71 |
71 |
$0.00 |