| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
3,868 |
3,648 |
$301K |
| V2020 |
Frames, purchases |
3,872 |
3,580 |
$238K |
| 92004 |
|
947 |
877 |
$92K |
| 92015 |
|
5,560 |
5,242 |
$90K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,513 |
1,420 |
$60K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,821 |
1,762 |
$47K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
193 |
168 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
289 |
277 |
$9K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
34 |
27 |
$1K |
| 99213 |
|
15 |
13 |
$824.28 |
| 99212 |
|
13 |
13 |
$487.27 |