| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
4,017 |
3,821 |
$229K |
| 92004 |
|
1,936 |
1,833 |
$147K |
| 92340 |
|
6,567 |
6,200 |
$110K |
| V2020 |
Vision svcs frames purchases |
6,203 |
5,848 |
$84K |
| V2784 |
Lens polycarb or equal |
4,874 |
4,574 |
$78K |
| V2745 |
Tint, any color/solid/grad |
3,510 |
3,348 |
$64K |
| 92015 |
|
5,661 |
5,380 |
$47K |
| V2100 |
Lens spher single plano 4.00 |
4,981 |
4,709 |
$46K |
| 99213 |
|
765 |
697 |
$24K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
330 |
323 |
$6K |
| 92083 |
|
156 |
151 |
$4K |
| V2755 |
Uv lens/es |
588 |
577 |
$2K |
| 92133 |
|
93 |
87 |
$2K |
| 92012 |
|
169 |
155 |
$1K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
27 |
27 |
$739.40 |
| 92134 |
|
40 |
38 |
$703.21 |
| S0621 |
Routine ophthalmological exa |
12 |
12 |
$298.00 |
| V2200 |
Lens spher bifoc plano 4.00d |
42 |
40 |
$0.77 |
| G8427 |
Docrev cur meds by elig clin |
695 |
656 |
$0.00 |
| V2760 |
Scratch resistant coating |
71 |
71 |
$0.00 |
| 1036F |
|
693 |
656 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
105 |
98 |
$0.00 |
| 83861 |
|
26 |
12 |
$0.00 |