| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
4,566 |
4,350 |
$388K |
| V2020 |
Frames, purchases |
5,964 |
5,576 |
$231K |
| 92004 |
|
1,630 |
1,559 |
$166K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,245 |
2,087 |
$139K |
| 92015 |
|
7,204 |
6,829 |
$98K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,906 |
1,741 |
$82K |
| 99214 |
|
764 |
689 |
$59K |
| 99213 |
|
654 |
577 |
$42K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
576 |
391 |
$15K |
| 92250 |
|
527 |
485 |
$13K |
| V2755 |
U-v lens, per lens |
359 |
351 |
$7K |
| 83861 |
|
58 |
24 |
$989.12 |
| V2300 |
Sphere, trifocal, plano to plus or minus 4.00d, per lens |
26 |
13 |
$961.99 |
| 83516 |
|
58 |
24 |
$507.32 |