| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
18,162 |
14,939 |
$1.03M |
| 92004 |
|
9,985 |
8,533 |
$684K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
16,536 |
12,902 |
$404K |
| V2020 |
Vision svcs frames purchases |
29,569 |
24,206 |
$379K |
| V2100 |
Lens spher single plano 4.00 |
11,448 |
8,396 |
$255K |
| 99211 |
|
17,300 |
15,253 |
$181K |
| V2200 |
Lens spher bifoc plano 4.00d |
2,085 |
1,615 |
$124K |
| S0580 |
Polycarb lens |
2,357 |
2,112 |
$121K |
| 92015 |
|
24,792 |
20,211 |
$102K |
| 92340 |
|
8,910 |
6,336 |
$74K |
| 99213 |
|
2,101 |
1,787 |
$67K |
| 92012 |
|
932 |
702 |
$35K |
| 92250 |
|
1,259 |
1,129 |
$34K |
| 92082 |
|
683 |
587 |
$24K |
| 92133 |
|
1,423 |
1,142 |
$23K |
| 92341 |
|
692 |
511 |
$6K |
| V2799 |
Misc vision item or service |
552 |
535 |
$4K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
225 |
174 |
$4K |
| V2784 |
Lens polycarb or equal |
270 |
204 |
$3K |
| 92134 |
|
123 |
105 |
$2K |
| 76514 |
|
246 |
219 |
$2K |
| 92083 |
|
32 |
26 |
$1K |
| 92310 |
|
13 |
13 |
$1K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
35 |
13 |
$767.09 |
| V2744 |
Tint photochromatic lens/es |
17 |
15 |
$338.00 |
| V2107 |
Spherocylinder 4.25d/12-2d |
20 |
12 |
$336.22 |
| 92201 |
|
31 |
26 |
$182.84 |
| V2750 |
Anti-reflective coating |
51 |
41 |
$11.00 |
| G8427 |
Docrev cur meds by elig clin |
370 |
245 |
$0.00 |