| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
7,303 |
7,148 |
$301K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
11,529 |
5,759 |
$241K |
| V2020 |
Frames, purchases |
9,559 |
9,223 |
$120K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,292 |
1,178 |
$67K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,219 |
1,595 |
$66K |
| 92012 |
|
1,471 |
1,431 |
$63K |
| 92004 |
|
513 |
511 |
$21K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
206 |
102 |
$6K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
115 |
115 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
18,495 |
8,934 |
$5K |
| 99213 |
|
158 |
142 |
$4K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
75 |
75 |
$3K |
| 99204 |
|
12 |
12 |
$988.00 |
| 92341 |
|
37 |
37 |
$510.00 |
| 92340 |
|
13 |
13 |
$196.95 |