| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
15,311 |
15,134 |
$141K |
| 99203 |
|
1,820 |
1,812 |
$102K |
| S0620 |
Routine ophthalmological exa |
5,308 |
5,253 |
$89K |
| 92340 |
|
5,496 |
5,412 |
$84K |
| S0621 |
Routine ophthalmological exa |
3,989 |
3,952 |
$51K |
| 92004 |
|
2,755 |
2,700 |
$45K |
| 99213 |
|
992 |
980 |
$44K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
3,481 |
3,444 |
$44K |
| 92341 |
|
1,962 |
1,943 |
$37K |
| 92014 |
|
2,007 |
1,966 |
$24K |
| V2100 |
Lens spher single plano 4.00 |
6,174 |
6,122 |
$23K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,270 |
1,250 |
$18K |
| V2200 |
Lens spher bifoc plano 4.00d |
2,657 |
2,602 |
$7K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
169 |
169 |
$2K |
| V2784 |
Lens polycarb or equal |
2,720 |
2,693 |
$1K |
| V2303 |
Lens sphcy trifocal 4.0/.12- |
48 |
48 |
$1K |
| V2300 |
Lens sphere trifocal 4.00d |
852 |
849 |
$724.85 |
| V2744 |
Tint photochromatic lens/es |
1,002 |
998 |
$549.00 |
| V2107 |
Spherocylinder 4.25d/12-2d |
13 |
13 |
$137.87 |
| V2745 |
Tint, any color/solid/grad |
25 |
25 |
$116.40 |
| V2220 |
Lens bifocal add over 3.25d |
25 |
25 |
$51.00 |
| V2755 |
Uv lens/es |
222 |
222 |
$0.00 |
| V2781 |
Progressive lens per lens |
820 |
816 |
$0.00 |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
26 |
24 |
$0.00 |
| V2750 |
Anti-reflective coating |
1,508 |
1,498 |
$0.00 |
| 92015 |
|
102 |
102 |
$0.00 |