| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
5,643 |
5,228 |
$83K |
| 99211 |
|
5,388 |
5,083 |
$68K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,793 |
2,593 |
$57K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
693 |
637 |
$38K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,432 |
1,362 |
$34K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
198 |
179 |
$10K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
29 |
28 |
$493.35 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
15 |
13 |
$348.12 |
| 92004 |
|
60 |
36 |
$0.00 |
| 92014 |
|
112 |
69 |
$0.00 |
| 92340 |
|
183 |
114 |
$0.00 |