| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
4,062 |
4,050 |
$1.20M |
| V2020 |
Vision svcs frames purchases |
8,887 |
8,835 |
$248K |
| V2784 |
Lens polycarb or equal |
3,931 |
3,270 |
$111K |
| 92004 |
|
1,320 |
1,320 |
$92K |
| V2219 |
Lens bifocal seg width over |
1,129 |
1,128 |
$88K |
| 92340 |
|
6,521 |
6,492 |
$87K |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
1,458 |
1,456 |
$84K |
| 92014 |
|
1,417 |
1,416 |
$81K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
3,443 |
3,362 |
$33K |
| 92341 |
|
1,815 |
1,814 |
$32K |
| 92015 |
|
2,460 |
2,459 |
$30K |
| V2100 |
Lens spher single plano 4.00 |
2,733 |
2,635 |
$25K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,122 |
1,087 |
$22K |
| V2200 |
Lens spher bifoc plano 4.00d |
895 |
832 |
$17K |
| V2199 |
Lens single vision not oth c |
1,038 |
519 |
$12K |
| V2299 |
Lens bifocal speciality |
258 |
129 |
$4K |
| V2107 |
Spherocylinder 4.25d/12-2d |
257 |
251 |
$3K |
| 92250 |
|
24 |
24 |
$1K |
| 92225 |
|
12 |
12 |
$310.50 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
26 |
25 |
$259.20 |
| V2755 |
Uv lens/es |
1,384 |
691 |
$0.00 |