| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
158,079 |
150,717 |
$1.22M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
87,465 |
83,463 |
$606K |
| V2100 |
Lens spher single plano 4.00 |
45,812 |
43,790 |
$292K |
| V2784 |
Lens polycarb or equal |
105,097 |
100,675 |
$203K |
| V2760 |
Scratch resistant coating |
104,814 |
100,460 |
$200K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
18,522 |
17,520 |
$144K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
13,238 |
12,630 |
$77K |
| V2107 |
Spherocylinder 4.25d/12-2d |
10,937 |
10,436 |
$66K |
| V2200 |
Lens spher bifoc plano 4.00d |
7,632 |
7,233 |
$50K |
| V2025 |
Eyeglasses delux frames |
1,048 |
972 |
$23K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
3,385 |
3,223 |
$18K |
| V2101 |
Single visn sphere 4.12-7.00 |
3,245 |
3,089 |
$18K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
2,320 |
2,217 |
$13K |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
1,760 |
1,651 |
$11K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
1,504 |
1,421 |
$9K |
| V2207 |
Lens sphcy bifocal 4.25-7d/. |
1,224 |
1,161 |
$8K |
| V2799 |
Misc vision item or service |
2,741 |
2,665 |
$8K |
| 92340 |
|
361 |
264 |
$5K |
| V2112 |
Spherocylindr 7.25d/2.25-4d |
785 |
736 |
$4K |
| V2109 |
Spherocylinder 4.25d/4.25-6d |
749 |
714 |
$4K |
| V2102 |
Singl visn sphere 7.12-20.00 |
155 |
152 |
$929.53 |
| V2208 |
Lens sphcy bifocal 4.25-7/2. |
64 |
54 |
$330.22 |
| V2211 |
Lens sphcy bifo 7.25-12/.25- |
50 |
43 |
$274.00 |
| V2201 |
Lens sphere bifocal 4.12-7.0 |
31 |
28 |
$189.00 |
| 99199 |
|
15 |
14 |
$0.00 |