| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
4,641 |
4,598 |
$228K |
| 92014 |
|
3,446 |
3,408 |
$166K |
| V2100 |
Lens spher single plano 4.00 |
5,725 |
5,676 |
$135K |
| V2020 |
Vision svcs frames purchases |
5,326 |
5,295 |
$101K |
| V2784 |
Lens polycarb or equal |
6,028 |
5,979 |
$35K |
| V2200 |
Lens spher bifoc plano 4.00d |
867 |
865 |
$25K |
| V2781 |
Progressive lens per lens |
418 |
416 |
$10K |
| V2025 |
Eyeglasses delux frames |
2,869 |
2,861 |
$3K |
| 92015 |
|
7,204 |
7,152 |
$1K |
| S0621 |
Routine ophthalmological exa |
33 |
27 |
$1K |
| S0620 |
Routine ophthalmological exa |
28 |
28 |
$1K |
| 92340 |
|
20 |
12 |
$79.04 |
| 92250 |
|
1,044 |
1,043 |
$21.99 |
| V2799 |
Misc vision item or service |
138 |
136 |
$0.00 |
| V2744 |
Tint photochromatic lens/es |
298 |
294 |
$0.00 |
| V2750 |
Anti-reflective coating |
1,810 |
1,799 |
$0.00 |
| V2745 |
Tint, any color/solid/grad |
306 |
303 |
$0.00 |