| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
3,015 |
2,950 |
$248K |
| 92004 |
|
1,593 |
1,574 |
$133K |
| V2020 |
Vision svcs frames purchases |
7,099 |
6,902 |
$112K |
| 92012 |
|
955 |
925 |
$69K |
| V2100 |
Lens spher single plano 4.00 |
3,405 |
1,905 |
$47K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
3,329 |
1,752 |
$37K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
3,251 |
1,655 |
$34K |
| 92250 |
|
643 |
632 |
$25K |
| V2410 |
Lens variab asphericity sing |
3,612 |
1,777 |
$11K |
| 99213 |
|
85 |
79 |
$5K |
| 92002 |
|
29 |
29 |
$1K |
| V2107 |
Spherocylinder 4.25d/12-2d |
154 |
79 |
$1K |
| V2200 |
Lens spher bifoc plano 4.00d |
43 |
24 |
$763.04 |
| 92340 |
|
4,839 |
4,733 |
$743.40 |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
24 |
14 |
$459.56 |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
23 |
13 |
$300.00 |
| V2784 |
Lens polycarb or equal |
698 |
354 |
$110.00 |
| 92341 |
|
387 |
380 |
$81.57 |
| S0580 |
Polycarb lens |
444 |
219 |
$78.00 |
| 92370 |
|
440 |
437 |
$45.00 |
| 92015 |
|
4,607 |
4,507 |
$0.02 |