| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
14,281 |
13,839 |
$1.04M |
| 92004 |
|
11,346 |
10,299 |
$930K |
| V2020 |
Vision svcs frames purchases |
27,008 |
25,328 |
$435K |
| 92250 |
|
8,700 |
8,209 |
$288K |
| V2100 |
Lens spher single plano 4.00 |
12,002 |
11,221 |
$285K |
| 99211 |
|
21,703 |
20,779 |
$278K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
9,382 |
8,877 |
$212K |
| V2784 |
Lens polycarb or equal |
4,113 |
3,879 |
$212K |
| 92015 |
|
8,090 |
7,993 |
$131K |
| 99214 |
|
1,722 |
1,567 |
$96K |
| 92081 |
|
2,323 |
2,271 |
$71K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
2,457 |
2,319 |
$53K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
809 |
752 |
$50K |
| 92340 |
|
2,976 |
2,824 |
$34K |
| V2799 |
Misc vision item or service |
1,245 |
1,218 |
$15K |
| V2101 |
Single visn sphere 4.12-7.00 |
507 |
464 |
$12K |
| V2200 |
Lens spher bifoc plano 4.00d |
201 |
162 |
$9K |
| 92285 |
|
498 |
474 |
$7K |
| S0580 |
Polycarb lens |
190 |
167 |
$4K |
| 99204 |
|
40 |
39 |
$3K |
| 76514 |
|
405 |
398 |
$3K |
| 92083 |
|
36 |
36 |
$2K |
| V2599 |
Contact lens/es other type |
17 |
14 |
$883.60 |
| 92133 |
|
40 |
32 |
$792.85 |
| 92310 |
|
15 |
12 |
$743.40 |
| V2744 |
Tint photochromatic lens/es |
14 |
13 |
$115.96 |