| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
13,867 |
11,685 |
$776K |
| 92015 |
|
19,858 |
16,939 |
$279K |
| 92004 |
|
3,750 |
3,397 |
$279K |
| 99214 |
|
1,147 |
1,049 |
$44K |
| 92012 |
|
981 |
837 |
$43K |
| 99213 |
|
552 |
403 |
$28K |
| 92133 |
|
818 |
721 |
$27K |
| V2100 |
Lens spher single plano 4.00 |
875 |
769 |
$5K |
| 92083 |
|
66 |
66 |
$4K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,745 |
2,471 |
$3K |
| V2020 |
Vision svcs frames purchases |
6,204 |
5,552 |
$3K |
| 92060 |
|
52 |
52 |
$3K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
245 |
213 |
$812.98 |
| V2025 |
Eyeglasses delux frames |
47 |
47 |
$558.36 |
| V2784 |
Lens polycarb or equal |
3,871 |
3,498 |
$312.00 |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
355 |
294 |
$169.78 |
| V2744 |
Tint photochromatic lens/es |
277 |
252 |
$28.34 |
| V2299 |
Lens bifocal speciality |
26 |
25 |
$0.00 |
| V2781 |
Progressive lens per lens |
26 |
25 |
$0.00 |
| 1036F |
|
63 |
61 |
$0.00 |
| V2750 |
Anti-reflective coating |
423 |
364 |
$0.00 |
| 2022F |
|
27 |
27 |
$0.00 |
| V2107 |
Spherocylinder 4.25d/12-2d |
33 |
29 |
$0.00 |
| 2027F |
|
17 |
17 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
71 |
69 |
$0.00 |