| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
2,805 |
2,433 |
$440K |
| 92004 |
|
2,837 |
2,553 |
$323K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,761 |
3,286 |
$224K |
| V2020 |
Frames, purchases |
4,015 |
3,472 |
$213K |
| 92014 |
|
1,316 |
1,205 |
$136K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,109 |
1,919 |
$118K |
| V2750 |
Anti-reflective coating, per lens |
3,602 |
3,142 |
$103K |
| 92340 |
|
3,995 |
3,450 |
$86K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
823 |
738 |
$48K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
265 |
252 |
$17K |
| 92015 |
|
4,365 |
3,957 |
$7K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
101 |
93 |
$6K |
| 99212 |
|
116 |
108 |
$5K |
| 99213 |
|
29 |
26 |
$2K |