| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
11,211 |
10,519 |
$164K |
| V2025 |
Eyeglasses delux frames |
2,571 |
2,387 |
$164K |
| 99211 |
|
11,082 |
10,512 |
$140K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
5,862 |
5,613 |
$138K |
| V2784 |
Lens polycarb or equal |
2,119 |
1,975 |
$113K |
| V2781 |
Progressive lens per lens |
706 |
668 |
$82K |
| V2100 |
Lens spher single plano 4.00 |
1,947 |
1,864 |
$45K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
516 |
493 |
$38K |
| 92340 |
|
1,828 |
1,745 |
$21K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
159 |
156 |
$4K |
| V2107 |
Spherocylinder 4.25d/12-2d |
88 |
87 |
$2K |
| V2799 |
Misc vision item or service |
190 |
187 |
$2K |
| V2101 |
Single visn sphere 4.12-7.00 |
13 |
13 |
$485.26 |