| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
274,196 |
268,043 |
$8.95M |
| 92004 |
|
167,087 |
163,433 |
$5.32M |
| V2020 |
Vision svcs frames purchases |
134,332 |
127,787 |
$5.22M |
| 92012 |
|
163,026 |
160,713 |
$5.15M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
67,496 |
60,871 |
$1.78M |
| 92002 |
|
39,028 |
38,372 |
$1.25M |
| V2784 |
Lens polycarb or equal |
47,276 |
47,110 |
$1.21M |
| 99213 |
|
29,049 |
26,840 |
$873K |
| 92015 |
|
86,876 |
82,412 |
$819K |
| 99214 |
|
17,712 |
16,138 |
$740K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
21,846 |
19,945 |
$599K |
| 99203 |
|
8,762 |
8,210 |
$379K |
| 92250 |
|
13,076 |
11,940 |
$251K |
| V2100 |
Lens spher single plano 4.00 |
10,829 |
9,758 |
$247K |
| 99204 |
|
3,573 |
3,109 |
$221K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
1,313 |
1,312 |
$126K |
| 92133 |
|
2,557 |
2,464 |
$54K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
1,469 |
1,378 |
$48K |
| 92134 |
|
2,154 |
2,042 |
$40K |
| V2750 |
Anti-reflective coating |
3,970 |
3,965 |
$39K |
| 68761 |
|
531 |
324 |
$31K |
| 92083 |
|
626 |
594 |
$29K |
| 92025 |
|
1,277 |
1,209 |
$23K |
| 99212 |
|
660 |
647 |
$14K |
| V2744 |
Tint photochromatic lens/es |
822 |
822 |
$8K |
| 92310 |
|
260 |
250 |
$7K |
| V2107 |
Spherocylinder 4.25d/12-2d |
322 |
284 |
$7K |
| 92060 |
|
226 |
183 |
$7K |
| 76514 |
|
633 |
609 |
$5K |
| 92136 |
|
63 |
54 |
$3K |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
26 |
26 |
$3K |
| V2799 |
Misc vision item or service |
289 |
279 |
$2K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
16 |
13 |
$350.91 |
| V2781 |
Progressive lens per lens |
26 |
26 |
$40.49 |