| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
8,216 |
7,573 |
$555K |
| 92004 |
|
4,024 |
3,775 |
$339K |
| V2020 |
Frames, purchases |
12,635 |
11,405 |
$201K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
6,364 |
5,155 |
$100K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,479 |
4,124 |
$88K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,665 |
1,470 |
$75K |
| 99211 |
|
5,797 |
5,308 |
$67K |
| 92340 |
|
5,545 |
5,167 |
$61K |
| 92012 |
|
492 |
366 |
$17K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
877 |
730 |
$12K |
| 92341 |
|
975 |
905 |
$9K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
435 |
373 |
$6K |
| 92250 |
|
302 |
235 |
$4K |
| 92133 |
|
408 |
376 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
118 |
59 |
$3K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
150 |
119 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
310 |
275 |
$2K |
| 99213 |
|
99 |
57 |
$2K |
| 92082 |
|
13 |
13 |
$455.09 |
| 92134 |
|
41 |
41 |
$407.70 |
| 92310 |
|
21 |
20 |
$320.00 |
| 76514 |
|
103 |
81 |
$235.85 |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
14 |
12 |
$200.30 |
| 92201 |
|
63 |
43 |
$54.60 |
| V2744 |
Tint, photochromatic, per lens |
27 |
24 |
$53.55 |
| 92015 |
|
12,641 |
10,952 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
63 |
55 |
$0.00 |
| 2026F |
|
108 |
108 |
$0.00 |