| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
8,111 |
7,718 |
$920K |
| V2020 |
Vision svcs frames purchases |
16,314 |
15,152 |
$662K |
| 92014 |
|
7,006 |
6,703 |
$651K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
7,548 |
7,067 |
$373K |
| 92015 |
|
16,979 |
16,131 |
$256K |
| V2100 |
Lens spher single plano 4.00 |
2,559 |
2,357 |
$113K |
| V2410 |
Lens variab asphericity sing |
632 |
567 |
$108K |
| V2755 |
Uv lens/es |
2,917 |
2,702 |
$79K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
939 |
838 |
$64K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
831 |
780 |
$37K |
| V2784 |
Lens polycarb or equal |
465 |
356 |
$24K |
| V2107 |
Spherocylinder 4.25d/12-2d |
124 |
118 |
$7K |
| V2200 |
Lens spher bifoc plano 4.00d |
39 |
37 |
$3K |
| 92002 |
|
42 |
38 |
$2K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
13 |
13 |
$557.18 |
| 92310 |
|
41 |
37 |
$435.00 |
| V2750 |
Anti-reflective coating |
19 |
16 |
$0.00 |