| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
3,044 |
2,921 |
$213K |
| 92004 |
|
1,857 |
1,735 |
$155K |
| V2020 |
Frames, purchases |
5,951 |
5,440 |
$84K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,646 |
3,372 |
$65K |
| 99211 |
|
5,232 |
4,929 |
$61K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
552 |
473 |
$27K |
| 92340 |
|
515 |
485 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
289 |
277 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
86 |
82 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
31 |
25 |
$1K |
| V2799 |
Vision item or service, miscellaneous |
95 |
84 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
59 |
51 |
$841.32 |
| 92310 |
|
30 |
27 |
$224.00 |
| 92015 |
|
4,713 |
4,360 |
$0.00 |