| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
6,936 |
6,720 |
$284K |
| 92015 |
|
6,315 |
6,150 |
$125K |
| 99213 |
|
2,783 |
2,409 |
$125K |
| 92004 |
|
2,056 |
2,007 |
$115K |
| V2020 |
Vision svcs frames purchases |
6,832 |
6,489 |
$114K |
| 92340 |
|
5,035 |
4,749 |
$90K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,259 |
2,146 |
$86K |
| V2784 |
Lens polycarb or equal |
3,308 |
3,166 |
$55K |
| V2750 |
Anti-reflective coating |
1,525 |
1,428 |
$38K |
| V2100 |
Lens spher single plano 4.00 |
652 |
623 |
$23K |
| V2410 |
Lens variab asphericity sing |
203 |
185 |
$22K |
| V2744 |
Tint photochromatic lens/es |
291 |
274 |
$6K |
| 92341 |
|
134 |
131 |
$3K |
| 68761 |
|
12 |
12 |
$2K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$1K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
12 |
12 |
$666.24 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
14 |
14 |
$600.82 |
| V2745 |
Tint, any color/solid/grad |
72 |
72 |
$580.12 |
| 92250 |
|
14 |
12 |
$345.63 |
| 92133 |
|
12 |
12 |
$307.34 |
| V2799 |
Misc vision item or service |
15 |
13 |
$163.25 |