| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological exa |
3,399 |
3,317 |
$243K |
| S0620 |
Routine ophthalmological exa |
2,680 |
2,612 |
$192K |
| V2020 |
Vision svcs frames purchases |
7,014 |
6,520 |
$168K |
| V2784 |
Lens polycarb or equal |
7,206 |
6,745 |
$143K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,883 |
4,553 |
$105K |
| 92250 |
|
2,358 |
2,264 |
$82K |
| 92014 |
|
927 |
852 |
$56K |
| V2025 |
Eyeglasses delux frames |
1,181 |
1,164 |
$44K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
1,139 |
1,060 |
$25K |
| V2100 |
Lens spher single plano 4.00 |
1,103 |
1,038 |
$23K |
| 99213 |
|
645 |
581 |
$19K |
| 92015 |
|
1,563 |
1,446 |
$16K |
| 92004 |
|
82 |
70 |
$6K |
| V2750 |
Anti-reflective coating |
208 |
198 |
$6K |
| V2107 |
Spherocylinder 4.25d/12-2d |
206 |
182 |
$4K |
| 92310 |
|
28 |
26 |
$2K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
14 |
13 |
$399.06 |
| V2755 |
Uv lens/es |
127 |
123 |
$169.71 |
| G8427 |
Docrev cur meds by elig clin |
230 |
213 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
27 |
27 |
$0.00 |