| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
7,677 |
7,628 |
$622K |
| 92014 |
|
4,445 |
4,383 |
$303K |
| S0620 |
Routine ophthalmological exa |
3,797 |
3,783 |
$151K |
| 92012 |
|
2,849 |
2,550 |
$144K |
| 92250 |
|
6,035 |
6,002 |
$142K |
| 92060 |
|
3,502 |
3,474 |
$130K |
| V2020 |
Vision svcs frames purchases |
3,453 |
3,440 |
$106K |
| 92015 |
|
9,205 |
9,098 |
$99K |
| S0621 |
Routine ophthalmological exa |
1,944 |
1,927 |
$97K |
| 92083 |
|
1,925 |
1,907 |
$68K |
| 92340 |
|
2,393 |
2,379 |
$47K |
| 92341 |
|
1,617 |
1,611 |
$37K |
| 92082 |
|
1,230 |
1,221 |
$33K |
| 92002 |
|
427 |
426 |
$20K |
| 99204 |
|
193 |
193 |
$19K |
| 92133 |
|
828 |
808 |
$17K |
| 92342 |
|
657 |
648 |
$15K |
| 92235 |
|
179 |
174 |
$13K |
| 99214 |
|
144 |
144 |
$10K |
| V2202 |
Lens sphere bifocal 7.12-20. |
239 |
239 |
$6K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
561 |
535 |
$6K |
| V2101 |
Single visn sphere 4.12-7.00 |
236 |
235 |
$4K |
| V2302 |
Lens sphere trifocal 7.12-20 |
146 |
145 |
$4K |
| 92134 |
|
95 |
91 |
$2K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
125 |
124 |
$2K |
| V2100 |
Lens spher single plano 4.00 |
212 |
212 |
$2K |
| V2200 |
Lens spher bifoc plano 4.00d |
109 |
109 |
$1K |
| V2102 |
Singl visn sphere 7.12-20.00 |
58 |
57 |
$1K |
| 92136 |
|
33 |
28 |
$825.95 |
| V2300 |
Lens sphere trifocal 4.00d |
14 |
14 |
$265.79 |
| V2113 |
Spherocylindr 7.25d/4.25-6d |
13 |
13 |
$192.50 |
| V2025 |
Eyeglasses delux frames |
36 |
36 |
$0.00 |