| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
|
38,902 |
38,790 |
$1.18M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
23,017 |
22,932 |
$536K |
| V2020 |
Vision svcs frames purchases |
33,458 |
33,398 |
$335K |
| V2100 |
Lens spher single plano 4.00 |
13,416 |
13,368 |
$303K |
| 92370 |
|
10,204 |
10,023 |
$275K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
6,046 |
6,018 |
$125K |
| V2107 |
Spherocylinder 4.25d/12-2d |
2,679 |
2,672 |
$56K |
| V2715 |
Prism lens/es |
1,605 |
1,598 |
$25K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
876 |
873 |
$18K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
640 |
639 |
$13K |
| V2101 |
Single visn sphere 4.12-7.00 |
507 |
504 |
$10K |
| 92012 |
|
83 |
72 |
$6K |
| 92015 |
|
270 |
255 |
$5K |
| 92014 |
|
30 |
30 |
$3K |
| V2200 |
Lens spher bifoc plano 4.00d |
38 |
38 |
$906.75 |
| V2109 |
Spherocylinder 4.25d/4.25-6d |
24 |
24 |
$390.60 |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
14 |
14 |
$320.85 |
| V2784 |
Lens polycarb or equal |
1,562 |
1,543 |
$75.00 |