| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
56,460 |
51,484 |
$2.97M |
| V2100 |
Lens spher single plano 4.00 |
37,324 |
32,026 |
$2.77M |
| 92004 |
|
28,458 |
25,887 |
$1.88M |
| 92340 |
|
62,051 |
56,537 |
$411K |
| V2025 |
Eyeglasses delux frames |
9,921 |
9,018 |
$384K |
| V2200 |
Lens spher bifoc plano 4.00d |
2,506 |
1,822 |
$293K |
| V2020 |
Vision svcs frames purchases |
80,128 |
72,019 |
$262K |
| 3072F |
|
1,793 |
1,612 |
$108K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
44,777 |
33,479 |
$27K |
| 92341 |
|
1,689 |
1,531 |
$17K |
| V2799 |
Misc vision item or service |
378 |
164 |
$11K |
| 2022F |
|
416 |
407 |
$6K |
| V2784 |
Lens polycarb or equal |
10,117 |
8,596 |
$4K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
2,568 |
1,614 |
$2K |
| V2750 |
Anti-reflective coating |
3,866 |
2,983 |
$1K |
| V2744 |
Tint photochromatic lens/es |
2,699 |
1,874 |
$789.82 |
| V2781 |
Progressive lens per lens |
1,848 |
729 |
$529.91 |
| G8398 |
Dil macular/fundus not perfo |
17,431 |
15,475 |
$294.00 |
| G8397 |
Dil macula/fundus exam/w doc |
23,968 |
21,612 |
$212.00 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
861 |
732 |
$147.50 |
| V2107 |
Spherocylinder 4.25d/12-2d |
300 |
246 |
$10.00 |
| 92015 |
|
1,711 |
1,709 |
$0.00 |
| 2021F |
|
45 |
45 |
$0.00 |
| S0595 |
New lenses in pts old frame |
12 |
12 |
$0.00 |
| 2023F |
|
43 |
43 |
$0.00 |
| 92310 |
|
17 |
16 |
$0.00 |