| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
11,674 |
11,662 |
$960K |
| 92004 |
|
11,001 |
10,983 |
$881K |
| 92012 |
|
2,145 |
2,111 |
$143K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
6,417 |
3,306 |
$141K |
| V2020 |
Frames, purchases |
7,486 |
7,315 |
$121K |
| 99213 |
|
1,147 |
1,073 |
$71K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,296 |
1,196 |
$71K |
| 92015 |
|
9,923 |
9,903 |
$42K |
| 92250 |
|
1,033 |
1,025 |
$40K |
| 99214 |
|
266 |
266 |
$21K |
| 92083 |
|
302 |
301 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
480 |
250 |
$10K |
| 92134 |
|
306 |
294 |
$9K |
| 92133 |
|
330 |
330 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
10,710 |
5,303 |
$5K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
210 |
101 |
$4K |
| 99204 |
|
26 |
26 |
$3K |
| 92002 |
|
39 |
39 |
$2K |
| 92136 |
|
85 |
81 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
54 |
25 |
$1K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
27 |
27 |
$1K |
| 83861 |
|
23 |
15 |
$510.30 |
| 92340 |
|
13 |
13 |
$195.00 |
| 76514 |
|
12 |
12 |
$111.91 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
28 |
12 |
$0.00 |
| 2023F |
|
17 |
16 |
$0.00 |