| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
11,998 |
11,716 |
$955K |
| V2784 |
Lens polycarb or equal |
19,736 |
19,118 |
$921K |
| 92004 |
|
7,334 |
7,140 |
$673K |
| V2020 |
Vision svcs frames purchases |
20,738 |
20,009 |
$597K |
| V2100 |
Lens spher single plano 4.00 |
9,574 |
9,220 |
$405K |
| 92340 |
|
15,605 |
15,115 |
$359K |
| T1013 |
Sign lang/oral interpreter |
11,940 |
7,028 |
$357K |
| 92015 |
|
19,891 |
19,392 |
$238K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
3,896 |
3,825 |
$158K |
| 92341 |
|
5,665 |
5,471 |
$154K |
| V2200 |
Lens spher bifoc plano 4.00d |
2,840 |
2,742 |
$141K |
| 99213 |
|
2,201 |
2,149 |
$121K |
| V2410 |
Lens variab asphericity sing |
1,064 |
1,047 |
$111K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,834 |
1,791 |
$101K |
| 92250 |
|
1,032 |
988 |
$27K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
119 |
117 |
$12K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
265 |
260 |
$10K |
| 99203 |
|
42 |
42 |
$3K |
| 92083 |
|
29 |
29 |
$1K |
| V2107 |
Spherocylinder 4.25d/12-2d |
17 |
15 |
$1K |
| 92134 |
|
37 |
35 |
$937.94 |
| 92133 |
|
16 |
16 |
$394.95 |
| 76514 |
|
14 |
13 |
$109.48 |