| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
8,927 |
8,858 |
$276K |
| 92014 |
|
3,754 |
3,713 |
$239K |
| 92004 |
|
2,320 |
2,303 |
$187K |
| 92340 |
|
8,462 |
8,390 |
$170K |
| 92250 |
|
4,185 |
4,154 |
$86K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
5,190 |
5,163 |
$85K |
| 92015 |
|
6,153 |
6,103 |
$70K |
| 92341 |
|
2,196 |
2,180 |
$50K |
| S0621 |
Routine ophthalmological exa |
875 |
871 |
$44K |
| S0620 |
Routine ophthalmological exa |
545 |
537 |
$26K |
| V2100 |
Lens spher single plano 4.00 |
1,676 |
1,645 |
$18K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
928 |
923 |
$15K |
| 92370 |
|
391 |
390 |
$7K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
420 |
418 |
$6K |
| V2107 |
Spherocylinder 4.25d/12-2d |
140 |
140 |
$2K |
| 76514 |
|
159 |
94 |
$1K |
| 99213 |
|
16 |
16 |
$849.44 |
| V2301 |
Lens sphere trifocal 4.12-7. |
26 |
26 |
$824.50 |
| 92342 |
|
27 |
27 |
$684.32 |
| 92134 |
|
13 |
13 |
$304.93 |
| V2784 |
Lens polycarb or equal |
12 |
12 |
$0.00 |