| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
3,970 |
3,699 |
$271K |
| 92004 |
|
2,283 |
2,149 |
$194K |
| V2020 |
Frames, purchases |
5,180 |
4,849 |
$83K |
| 92012 |
|
1,549 |
1,310 |
$68K |
| 99213 |
|
1,177 |
981 |
$45K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,469 |
2,326 |
$40K |
| 92083 |
|
985 |
894 |
$40K |
| 99211 |
|
3,019 |
2,916 |
$40K |
| 92250 |
|
714 |
656 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,402 |
1,321 |
$22K |
| 92340 |
|
1,030 |
950 |
$10K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
182 |
167 |
$10K |
| 68761 |
|
101 |
85 |
$10K |
| 92133 |
|
73 |
68 |
$1K |
| 92341 |
|
61 |
59 |
$457.32 |
| V2799 |
Vision item or service, miscellaneous |
30 |
30 |
$304.61 |
| 3072F |
|
48 |
41 |
$0.00 |