| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
15,613 |
14,923 |
$1.76M |
| 92014 |
|
15,413 |
14,758 |
$1.42M |
| V2020 |
Vision svcs frames purchases |
26,202 |
24,429 |
$1.07M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
11,917 |
11,212 |
$585K |
| 92015 |
|
32,755 |
31,294 |
$499K |
| V2100 |
Lens spher single plano 4.00 |
5,892 |
5,490 |
$277K |
| V2410 |
Lens variab asphericity sing |
1,002 |
932 |
$155K |
| V2755 |
Uv lens/es |
3,303 |
3,111 |
$93K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
892 |
827 |
$51K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
484 |
446 |
$22K |
| V2200 |
Lens spher bifoc plano 4.00d |
256 |
244 |
$13K |
| V2107 |
Spherocylinder 4.25d/12-2d |
227 |
213 |
$12K |
| V2784 |
Lens polycarb or equal |
261 |
203 |
$9K |
| 99213 |
|
51 |
41 |
$3K |
| 92310 |
|
87 |
76 |
$1K |
| V2750 |
Anti-reflective coating |
43 |
41 |
$210.00 |
| V2781 |
Progressive lens per lens |
12 |
12 |
$17.50 |