| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
2,479 |
2,454 |
$196K |
| 92060 |
|
2,786 |
2,773 |
$147K |
| 99204 |
|
1,002 |
999 |
$142K |
| 92004 |
|
1,345 |
1,345 |
$125K |
| 92014 |
|
1,261 |
1,258 |
$113K |
| 92012 |
|
1,857 |
1,842 |
$112K |
| 99203 |
|
880 |
880 |
$87K |
| 99214 |
|
534 |
533 |
$59K |
| V2020 |
Frames, purchases |
1,441 |
1,415 |
$52K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,413 |
1,356 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
676 |
434 |
$26K |
| 92015 |
|
5,009 |
5,003 |
$10K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
58 |
41 |
$3K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
31 |
15 |
$1K |
| 92002 |
|
12 |
12 |
$498.22 |
| 99072 |
|
1,626 |
1,609 |
$0.00 |