| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
14,168 |
13,984 |
$427K |
| 92014 |
|
4,213 |
4,157 |
$246K |
| S0621 |
Routine ophthalmological exa |
4,857 |
4,806 |
$233K |
| 92340 |
|
11,765 |
11,635 |
$227K |
| S0620 |
Routine ophthalmological exa |
4,819 |
4,783 |
$223K |
| 92004 |
|
1,823 |
1,794 |
$131K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
8,337 |
6,345 |
$76K |
| 92341 |
|
3,323 |
3,271 |
$72K |
| 92015 |
|
5,785 |
5,704 |
$63K |
| V2100 |
Lens spher single plano 4.00 |
6,241 |
4,622 |
$51K |
| 92012 |
|
1,157 |
1,030 |
$50K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
2,494 |
1,763 |
$24K |
| 92134 |
|
934 |
926 |
$18K |
| 92065 |
|
377 |
205 |
$11K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
892 |
737 |
$10K |
| V2200 |
Lens spher bifoc plano 4.00d |
759 |
567 |
$8K |
| V2025 |
Eyeglasses delux frames |
65 |
65 |
$2K |
| 92250 |
|
97 |
96 |
$2K |
| 92342 |
|
81 |
78 |
$2K |
| V2107 |
Spherocylinder 4.25d/12-2d |
150 |
133 |
$2K |
| 99213 |
|
29 |
28 |
$2K |
| 92133 |
|
39 |
39 |
$745.91 |
| V2303 |
Lens sphcy trifocal 4.0/.12- |
12 |
12 |
$324.88 |
| V2784 |
Lens polycarb or equal |
270 |
269 |
$222.00 |