| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
1,931 |
1,927 |
$91K |
| 99243 |
|
901 |
880 |
$66K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,589 |
1,274 |
$55K |
| 92250 |
|
1,255 |
1,227 |
$50K |
| V2020 |
Frames, purchases |
2,645 |
2,604 |
$47K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
737 |
389 |
$33K |
| 99214 |
|
303 |
291 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
190 |
94 |
$4K |
| 92004 |
|
28 |
28 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,024 |
1,975 |
$1K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
48 |
47 |
$680.00 |