| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
|
14,888 |
14,480 |
$279K |
| V2784 |
Lens polycarb or equal |
10,474 |
10,227 |
$276K |
| V2020 |
Vision svcs frames purchases |
10,306 |
10,039 |
$197K |
| 99203 |
|
3,464 |
3,379 |
$192K |
| 99213 |
|
3,695 |
3,564 |
$152K |
| 92340 |
|
6,405 |
6,296 |
$130K |
| 92014 |
|
2,063 |
2,034 |
$94K |
| 92004 |
|
1,725 |
1,683 |
$87K |
| 92341 |
|
2,277 |
2,183 |
$57K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,998 |
4,945 |
$51K |
| 99204 |
|
617 |
594 |
$49K |
| 99214 |
|
823 |
784 |
$47K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,843 |
1,740 |
$39K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
249 |
238 |
$28K |
| V2100 |
Lens spher single plano 4.00 |
2,584 |
2,559 |
$24K |
| V2200 |
Lens spher bifoc plano 4.00d |
595 |
566 |
$8K |
| 92342 |
|
273 |
261 |
$7K |
| V2303 |
Lens sphcy trifocal 4.0/.12- |
230 |
223 |
$6K |
| V2107 |
Spherocylinder 4.25d/12-2d |
674 |
667 |
$6K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
646 |
641 |
$5K |
| V2101 |
Single visn sphere 4.12-7.00 |
129 |
128 |
$1K |
| V2715 |
Prism lens/es |
214 |
209 |
$945.00 |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
13 |
12 |
$155.68 |
| S0580 |
Polycarb lens |
31 |
31 |
$120.00 |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
12 |
12 |
$97.28 |