| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
3,263 |
2,906 |
$212K |
| 92004 |
|
1,531 |
1,348 |
$121K |
| V2020 |
Frames, purchases |
5,794 |
4,777 |
$79K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,007 |
2,589 |
$51K |
| 99211 |
|
3,082 |
2,813 |
$38K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
46 |
43 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
157 |
122 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
105 |
93 |
$2K |
| V2799 |
Vision item or service, miscellaneous |
116 |
108 |
$2K |
| 92340 |
|
49 |
46 |
$444.60 |
| 99070 |
|
60 |
52 |
$0.00 |
| 92015 |
|
920 |
782 |
$0.00 |