| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
20,943 |
17,832 |
$905K |
| 92250 |
|
14,545 |
12,803 |
$604K |
| 92340 |
|
20,290 |
17,730 |
$556K |
| 92004 |
|
8,421 |
7,256 |
$374K |
| V2025 |
Eyeglasses delux frames |
10,164 |
9,395 |
$357K |
| 92015 |
|
19,710 |
17,628 |
$316K |
| V2100 |
Lens spher single plano 4.00 |
11,503 |
10,378 |
$279K |
| V2784 |
Lens polycarb or equal |
9,379 |
8,947 |
$110K |
| V2020 |
Vision svcs frames purchases |
4,573 |
4,366 |
$109K |
| 92225 |
|
2,744 |
1,453 |
$102K |
| 92012 |
|
2,217 |
1,838 |
$93K |
| V2200 |
Lens spher bifoc plano 4.00d |
963 |
892 |
$48K |
| 92226 |
|
1,075 |
595 |
$41K |
| 92341 |
|
1,082 |
1,017 |
$31K |
| 92020 |
|
1,575 |
1,327 |
$30K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,924 |
1,904 |
$21K |
| S0621 |
Routine ophthalmological exa |
201 |
201 |
$9K |
| V2110 |
Spherocylinder 4.25d/over 6d |
399 |
372 |
$5K |
| S0620 |
Routine ophthalmological exa |
111 |
110 |
$5K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
110 |
110 |
$2K |
| 92310 |
|
37 |
33 |
$2K |
| 92201 |
|
142 |
53 |
$1K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
106 |
105 |
$931.48 |
| 92202 |
|
130 |
45 |
$850.83 |
| 92083 |
|
17 |
13 |
$625.37 |
| V2107 |
Spherocylinder 4.25d/12-2d |
65 |
65 |
$612.48 |