| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
4,585 |
4,396 |
$331K |
| 92004 |
|
2,495 |
2,367 |
$215K |
| V2020 |
Frames, purchases |
8,419 |
7,981 |
$155K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,129 |
3,958 |
$85K |
| 99211 |
|
6,205 |
6,072 |
$82K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
592 |
573 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
571 |
558 |
$12K |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
432 |
422 |
$12K |
| 92340 |
|
750 |
692 |
$9K |
| 99212 |
|
238 |
208 |
$5K |
| 92015 |
|
1,181 |
1,077 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
160 |
153 |
$3K |
| 92250 |
|
79 |
69 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
40 |
37 |
$2K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
66 |
65 |
$2K |
| 99213 |
|
23 |
17 |
$780.78 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
26 |
25 |
$642.02 |
| 92083 |
|
12 |
12 |
$604.64 |
| V2799 |
Vision item or service, miscellaneous |
24 |
24 |
$327.30 |
| 92285 |
|
15 |
13 |
$259.35 |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
17 |
14 |
$97.64 |
| 2023F |
|
45 |
45 |
$0.00 |
| V2756 |
Eye glass case |
33 |
29 |
$0.00 |