| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
7,216 |
7,212 |
$294K |
| V2020 |
Frames, purchases |
8,073 |
8,013 |
$157K |
| 92340 |
|
6,345 |
6,255 |
$107K |
| 92014 |
|
2,355 |
2,353 |
$84K |
| 92015 |
|
10,070 |
10,051 |
$77K |
| 92133 |
|
1,169 |
1,156 |
$37K |
| 92250 |
|
927 |
922 |
$35K |
| 99213 |
|
1,460 |
1,401 |
$32K |
| 92341 |
|
1,070 |
1,067 |
$29K |
| 92083 |
|
1,191 |
1,181 |
$28K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
708 |
558 |
$7K |
| 99211 |
|
313 |
311 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
176 |
162 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
98 |
82 |
$943.98 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
87 |
53 |
$806.40 |
| 92002 |
|
12 |
12 |
$411.73 |
| 99214 |
|
30 |
30 |
$369.89 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
12 |
$123.13 |