| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
27,856 |
25,260 |
$1.49M |
| V2020 |
Vision svcs frames purchases |
41,206 |
37,064 |
$931K |
| V2100 |
Lens spher single plano 4.00 |
38,260 |
34,343 |
$705K |
| 92340 |
|
18,752 |
17,015 |
$435K |
| 92004 |
|
6,765 |
5,939 |
$321K |
| V2784 |
Lens polycarb or equal |
23,052 |
20,939 |
$173K |
| V2200 |
Lens spher bifoc plano 4.00d |
3,355 |
3,044 |
$86K |
| V2781 |
Progressive lens per lens |
1,543 |
1,184 |
$34K |
| 92370 |
|
1,814 |
1,721 |
$31K |
| V2750 |
Anti-reflective coating |
7,845 |
6,615 |
$30K |
| 92341 |
|
1,146 |
1,038 |
$25K |
| 92015 |
|
2,919 |
2,694 |
$19K |
| 92353 |
|
999 |
950 |
$18K |
| V2500 |
Contact lens pmma spherical |
97 |
94 |
$9K |
| V2599 |
Contact lens/es other type |
134 |
133 |
$8K |
| 92250 |
|
1,497 |
1,252 |
$8K |
| V2520 |
Contact lens hydrophilic |
69 |
66 |
$7K |
| 99213 |
|
138 |
102 |
$3K |
| 99203 |
|
44 |
39 |
$2K |
| V2521 |
Cntct lens hydrophilic toric |
15 |
14 |
$2K |
| 92310 |
|
169 |
118 |
$2K |
| 99202 |
|
14 |
12 |
$460.00 |
| 99212 |
|
18 |
12 |
$370.80 |
| V2760 |
Scratch resistant coating |
116 |
114 |
$307.50 |
| 92342 |
|
284 |
182 |
$163.02 |
| V2799 |
Misc vision item or service |
146 |
141 |
$45.00 |
| V2744 |
Tint photochromatic lens/es |
44 |
29 |
$0.00 |
| S0500 |
Dispos cont lens |
128 |
120 |
$0.00 |
| S0620 |
Routine ophthalmological exa |
115 |
114 |
$0.00 |
| S0621 |
Routine ophthalmological exa |
227 |
224 |
$0.00 |