| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Lens variab asphericity sing |
23,241 |
20,329 |
$3.26M |
| 92014 |
|
21,588 |
20,356 |
$2.18M |
| V2020 |
Vision svcs frames purchases |
37,551 |
32,447 |
$1.49M |
| 92004 |
|
8,971 |
8,457 |
$1.07M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
21,865 |
19,285 |
$907K |
| V2784 |
Lens polycarb or equal |
34,767 |
30,376 |
$865K |
| 92340 |
|
36,154 |
31,239 |
$646K |
| V2100 |
Lens spher single plano 4.00 |
8,436 |
7,619 |
$325K |
| V2750 |
Anti-reflective coating |
10,017 |
8,624 |
$283K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
5,654 |
4,846 |
$266K |
| 99212 |
|
1,551 |
1,443 |
$60K |
| 99213 |
|
798 |
710 |
$50K |
| V2107 |
Spherocylinder 4.25d/12-2d |
956 |
774 |
$40K |
| 99211 |
|
2,224 |
2,123 |
$38K |
| 92015 |
|
31,242 |
29,426 |
$33K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
514 |
432 |
$25K |
| V2430 |
Lens variable asphericity bi |
67 |
57 |
$8K |
| 92341 |
|
341 |
306 |
$7K |
| V2118 |
Lens aniseikonic single |
71 |
65 |
$4K |
| V2200 |
Lens spher bifoc plano 4.00d |
113 |
61 |
$3K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
56 |
52 |
$3K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
76 |
42 |
$2K |
| 92012 |
|
12 |
12 |
$860.28 |