| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
2,498 |
1,828 |
$112K |
| 92004 |
|
1,787 |
1,375 |
$106K |
| 92015 |
|
4,326 |
3,218 |
$75K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,266 |
1,376 |
$45K |
| V2020 |
Frames, purchases |
3,637 |
2,609 |
$40K |
| 99211 |
|
2,393 |
2,136 |
$24K |
| 92012 |
|
527 |
387 |
$15K |
| 92340 |
|
1,055 |
420 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
150 |
132 |
$4K |
| V2025 |
Deluxe frame |
59 |
59 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
67 |
40 |
$3K |
| 92250 |
|
155 |
82 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
13 |
$359.00 |
| 92227 |
|
15 |
14 |
$79.80 |
| V2220 |
Bifocal add over 3.25d |
53 |
50 |
$0.02 |
| 3072F |
|
305 |
258 |
$0.00 |