| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
3,331 |
3,001 |
$142K |
| 92004 |
|
2,074 |
1,848 |
$94K |
| 92340 |
|
3,113 |
2,808 |
$87K |
| 92015 |
|
4,826 |
4,343 |
$81K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
666 |
511 |
$39K |
| 92012 |
|
607 |
507 |
$27K |
| V2020 |
Frames, purchases |
792 |
769 |
$24K |
| V2025 |
Deluxe frame |
798 |
640 |
$16K |
| 99213 |
|
460 |
428 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
715 |
684 |
$8K |
| 92341 |
|
203 |
193 |
$6K |
| 92250 |
|
166 |
153 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
395 |
375 |
$4K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
12 |
12 |
$555.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$407.45 |