| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
12,845 |
12,291 |
$902K |
| 92004 |
|
6,291 |
5,963 |
$535K |
| V2020 |
Vision svcs frames purchases |
19,033 |
17,924 |
$317K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
10,255 |
9,549 |
$175K |
| 99211 |
|
10,126 |
9,779 |
$132K |
| V2100 |
Lens spher single plano 4.00 |
5,011 |
4,727 |
$86K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,045 |
967 |
$53K |
| V2200 |
Lens spher bifoc plano 4.00d |
1,033 |
919 |
$45K |
| 92340 |
|
3,923 |
3,566 |
$43K |
| 92012 |
|
703 |
647 |
$31K |
| V2781 |
Progressive lens per lens |
280 |
261 |
$29K |
| 92250 |
|
1,052 |
907 |
$27K |
| V2107 |
Spherocylinder 4.25d/12-2d |
607 |
577 |
$11K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
622 |
580 |
$9K |
| V2799 |
Misc vision item or service |
338 |
311 |
$3K |
| 92341 |
|
153 |
146 |
$2K |
| 92342 |
|
36 |
36 |
$444.96 |
| V2101 |
Single visn sphere 4.12-7.00 |
12 |
12 |
$166.05 |
| 2025F |
|
63 |
53 |
$5.00 |
| 92015 |
|
18,320 |
16,728 |
$0.00 |