| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
8,284 |
7,725 |
$595K |
| 92340 |
|
9,947 |
8,993 |
$403K |
| 92004 |
|
4,402 |
4,148 |
$352K |
| 92015 |
|
13,145 |
12,223 |
$271K |
| V2020 |
Vision svcs frames purchases |
12,332 |
11,152 |
$249K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
6,598 |
5,984 |
$106K |
| 92341 |
|
1,465 |
1,363 |
$66K |
| V2784 |
Lens polycarb or equal |
9,459 |
8,476 |
$47K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,312 |
1,234 |
$31K |
| V2100 |
Lens spher single plano 4.00 |
2,071 |
1,854 |
$19K |
| V2025 |
Eyeglasses delux frames |
311 |
305 |
$17K |
| 92250 |
|
942 |
816 |
$14K |
| V2755 |
Uv lens/es |
2,560 |
2,400 |
$14K |
| 99213 |
|
340 |
293 |
$12K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
591 |
535 |
$8K |
| V2107 |
Spherocylinder 4.25d/12-2d |
431 |
394 |
$5K |
| 00000 |
|
202 |
36 |
$5K |
| 92012 |
|
105 |
88 |
$4K |
| V2750 |
Anti-reflective coating |
600 |
548 |
$3K |
| 92370 |
|
110 |
97 |
$2K |
| V2200 |
Lens spher bifoc plano 4.00d |
94 |
84 |
$1K |
| 99212 |
|
26 |
24 |
$830.37 |
| V2756 |
Eye glass case |
154 |
120 |
$26.86 |
| V2744 |
Tint photochromatic lens/es |
14 |
12 |
$0.00 |
| G8427 |
Docrev cur meds by elig clin |
14 |
14 |
$0.00 |