| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
14,363 |
13,658 |
$811K |
| V2784 |
Lens polycarb or equal |
24,737 |
11,943 |
$711K |
| 92060 |
|
12,582 |
11,372 |
$686K |
| 92014 |
|
6,024 |
5,540 |
$628K |
| 92012 |
|
6,959 |
6,091 |
$502K |
| 92004 |
|
3,877 |
3,532 |
$481K |
| 92340 |
|
15,245 |
14,424 |
$314K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
11,260 |
6,843 |
$312K |
| 92015 |
|
7,596 |
6,691 |
$165K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
4,442 |
2,860 |
$135K |
| V2100 |
Lens spher single plano 4.00 |
3,849 |
2,575 |
$121K |
| V2107 |
Spherocylinder 4.25d/12-2d |
2,202 |
1,477 |
$78K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
203 |
154 |
$8K |
| 92201 |
|
216 |
144 |
$3K |
| 99233 |
Prolong inpt eval add15 m |
24 |
15 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
12 |
12 |
$2K |
| 99204 |
|
13 |
12 |
$2K |
| 99214 |
|
12 |
12 |
$1K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
34 |
24 |
$1K |
| V2101 |
Single visn sphere 4.12-7.00 |
19 |
15 |
$665.87 |
| 92226 |
|
14 |
12 |
$289.80 |