| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
7,922 |
7,621 |
$237K |
| 92004 |
|
3,080 |
3,009 |
$224K |
| 92014 |
|
3,172 |
3,132 |
$214K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
6,643 |
6,106 |
$206K |
| 92340 |
|
7,427 |
7,202 |
$144K |
| 92341 |
|
3,136 |
3,050 |
$73K |
| 92015 |
|
7,387 |
7,250 |
$72K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,657 |
3,012 |
$68K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,546 |
1,607 |
$67K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
925 |
615 |
$16K |
| 92012 |
|
410 |
387 |
$9K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
241 |
186 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
215 |
189 |
$3K |
| 99213 |
|
44 |
41 |
$3K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
52 |
51 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
61 |
38 |
$1K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
36 |
32 |
$763.32 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
17 |
13 |
$395.20 |
| 92370 |
|
66 |
66 |
$232.62 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
15 |
13 |
$220.36 |