| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
11,360 |
11,343 |
$519K |
| 92014 |
|
7,226 |
7,170 |
$401K |
| 92012 |
|
10,152 |
9,721 |
$397K |
| 92083 |
|
5,095 |
5,070 |
$249K |
| 68761 |
|
2,629 |
1,796 |
$220K |
| 92004 |
|
3,219 |
3,215 |
$210K |
| V2020 |
Frames, purchases |
16,586 |
16,403 |
$200K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
9,645 |
6,131 |
$135K |
| 92133 |
|
3,586 |
3,579 |
$106K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
7,437 |
5,109 |
$98K |
| 92285 |
|
3,805 |
3,577 |
$79K |
| 92340 |
|
3,987 |
3,976 |
$53K |
| 92226 |
|
2,000 |
1,304 |
$34K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,377 |
953 |
$31K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,551 |
1,548 |
$27K |
| 99214 |
|
430 |
430 |
$26K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,128 |
4,061 |
$24K |
| 92225 |
|
1,340 |
874 |
$23K |
| 99213 |
|
624 |
614 |
$23K |
| 92002 |
|
634 |
634 |
$23K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,238 |
869 |
$22K |
| 92341 |
|
787 |
786 |
$14K |
| 92201 |
|
770 |
529 |
$12K |
| 92202 |
|
959 |
643 |
$11K |
| 92015 |
|
1,524 |
1,520 |
$9K |
| 99212 |
|
344 |
334 |
$8K |
| 92020 |
|
444 |
443 |
$6K |
| 92132 |
|
227 |
227 |
$5K |
| 76514 |
|
626 |
625 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
383 |
336 |
$4K |
| 92025 |
|
161 |
161 |
$3K |
| 99204 |
|
30 |
30 |
$3K |
| 99211 |
|
147 |
146 |
$2K |
| 92134 |
|
37 |
37 |
$1K |
| V2219 |
Bifocal seg width over 28 mm |
13 |
13 |
$1K |
| V2755 |
U-v lens, per lens |
168 |
83 |
$0.00 |