| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
|
1,826 |
1,656 |
$26K |
| 92014 |
|
8,418 |
8,166 |
$25K |
| V2100 |
Lens spher single plano 4.00 |
26,559 |
14,391 |
$24K |
| 92004 |
|
7,793 |
7,533 |
$21K |
| V2020 |
Vision svcs frames purchases |
18,274 |
17,584 |
$20K |
| 99214 |
|
242 |
242 |
$10K |
| V2200 |
Lens spher bifoc plano 4.00d |
3,614 |
2,141 |
$7K |
| 99213 |
|
141 |
140 |
$4K |
| 92015 |
|
979 |
859 |
$3K |
| V2300 |
Lens sphere trifocal 4.00d |
1,935 |
1,063 |
$2K |
| 92341 |
|
119 |
108 |
$2K |
| V2784 |
Lens polycarb or equal |
9,190 |
4,832 |
$2K |
| 92250 |
|
6,158 |
5,848 |
$1K |
| V2500 |
Contact lens pmma spherical |
26 |
24 |
$1K |
| 92310 |
|
652 |
628 |
$510.00 |
| V2520 |
Contact lens hydrophilic |
53 |
52 |
$26.60 |
| V2781 |
Progressive lens per lens |
686 |
391 |
$0.00 |
| S0500 |
Dispos cont lens |
635 |
635 |
$0.00 |
| S0581 |
Nonstnd lens |
272 |
133 |
$0.00 |
| V2744 |
Tint photochromatic lens/es |
1,601 |
833 |
$0.00 |
| V2755 |
Uv lens/es |
4,043 |
1,965 |
$0.00 |
| V2799 |
Misc vision item or service |
836 |
559 |
$0.00 |
| V2750 |
Anti-reflective coating |
6,638 |
3,444 |
$0.00 |
| V2797 |
Vis item/svc in other code |
476 |
455 |
$0.00 |