| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Lens spher single plano 4.00 |
17,046 |
15,974 |
$894K |
| 92014 |
|
16,412 |
15,079 |
$627K |
| V2020 |
Vision svcs frames purchases |
21,829 |
20,000 |
$457K |
| 99213 |
|
10,375 |
8,651 |
$383K |
| 92004 |
|
7,306 |
6,893 |
$361K |
| S0621 |
Routine ophthalmological exa |
4,740 |
4,068 |
$312K |
| 99214 |
|
5,147 |
4,443 |
$304K |
| 99204 |
|
2,150 |
1,885 |
$201K |
| 92015 |
|
13,392 |
11,903 |
$158K |
| 92012 |
|
5,979 |
5,251 |
$156K |
| V2200 |
Lens spher bifoc plano 4.00d |
2,258 |
2,067 |
$155K |
| 66984 |
|
711 |
576 |
$137K |
| V2784 |
Lens polycarb or equal |
4,158 |
3,303 |
$130K |
| 92134 |
|
5,529 |
4,654 |
$101K |
| S0620 |
Routine ophthalmological exa |
1,560 |
1,284 |
$95K |
| 92083 |
|
2,942 |
2,607 |
$84K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,253 |
1,861 |
$80K |
| V2520 |
Contact lens hydrophilic |
668 |
634 |
$77K |
| S0500 |
Dispos cont lens |
886 |
729 |
$74K |
| V2521 |
Cntct lens hydrophilic toric |
552 |
526 |
$65K |
| 92133 |
|
2,833 |
2,443 |
$58K |
| 99203 |
|
951 |
845 |
$49K |
| 92250 |
|
2,224 |
1,921 |
$48K |
| 67028 |
|
1,448 |
943 |
$48K |
| V2599 |
Contact lens/es other type |
197 |
197 |
$32K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
558 |
423 |
$25K |
| 92310 |
|
394 |
355 |
$21K |
| 99212 |
|
608 |
522 |
$17K |
| V2025 |
Eyeglasses delux frames |
659 |
659 |
$8K |
| 92136 |
|
385 |
305 |
$8K |
| 92020 |
|
626 |
539 |
$8K |
| 92002 |
|
151 |
143 |
$6K |
| 92326 |
|
93 |
92 |
$5K |
| 83861 |
|
453 |
204 |
$4K |
| 76514 |
|
473 |
422 |
$2K |
| 76519 |
|
60 |
51 |
$375.69 |
| 92340 |
|
84 |
78 |
$0.00 |