| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
3,363 |
3,285 |
$252K |
| V2020 |
Vision svcs frames purchases |
9,890 |
9,783 |
$251K |
| 92340 |
|
8,866 |
8,618 |
$157K |
| 92014 |
|
2,306 |
2,225 |
$143K |
| 92015 |
|
8,085 |
7,806 |
$80K |
| 92341 |
|
3,185 |
3,093 |
$65K |
| 92083 |
|
2,686 |
2,265 |
$65K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,749 |
3,943 |
$52K |
| S0620 |
Routine ophthalmological exa |
1,300 |
1,279 |
$50K |
| 92342 |
|
1,511 |
1,486 |
$33K |
| 92250 |
|
1,249 |
1,206 |
$30K |
| V2100 |
Lens spher single plano 4.00 |
2,069 |
1,897 |
$27K |
| 92012 |
|
558 |
545 |
$24K |
| S0621 |
Routine ophthalmological exa |
608 |
599 |
$23K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,809 |
1,420 |
$23K |
| V2303 |
Lens sphcy trifocal 4.0/.12- |
858 |
678 |
$21K |
| 92002 |
|
364 |
349 |
$15K |
| 92060 |
|
511 |
478 |
$15K |
| V2200 |
Lens spher bifoc plano 4.00d |
577 |
525 |
$11K |
| 92020 |
|
580 |
545 |
$8K |
| 92100 |
|
214 |
191 |
$7K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
362 |
302 |
$4K |
| 99203 |
|
21 |
19 |
$1K |