| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
5,938 |
5,816 |
$158K |
| 92250 |
|
2,291 |
2,277 |
$107K |
| 92012 |
|
2,396 |
2,378 |
$94K |
| 92002 |
|
2,447 |
2,439 |
$91K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,752 |
2,260 |
$65K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,149 |
2,089 |
$62K |
| 92004 |
|
897 |
894 |
$48K |
| 92014 |
|
610 |
607 |
$31K |
| 99213 |
|
430 |
417 |
$20K |
| 92015 |
|
559 |
557 |
$9K |
| 92340 |
|
497 |
496 |
$8K |
| 92083 |
|
132 |
130 |
$7K |
| 92133 |
|
213 |
210 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,401 |
2,396 |
$6K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
61 |
53 |
$3K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
23 |
12 |
$476.28 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
13 |
13 |
$440.00 |
| 92020 |
|
26 |
26 |
$438.31 |
| V2755 |
U-v lens, per lens |
1,418 |
696 |
$0.00 |