| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
12,668 |
11,365 |
$532K |
| V2784 |
Lens polycarb or equal |
5,815 |
5,077 |
$352K |
| V2100 |
Lens spher single plano 4.00 |
7,119 |
6,468 |
$340K |
| V2760 |
Scratch resistant coating |
12,624 |
11,330 |
$241K |
| 92014 |
|
2,629 |
2,438 |
$161K |
| 92012 |
|
2,823 |
2,755 |
$134K |
| V2200 |
Lens spher bifoc plano 4.00d |
1,157 |
1,109 |
$69K |
| 92370 |
|
6,562 |
5,709 |
$63K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
716 |
652 |
$59K |
| 92015 |
|
7,620 |
7,234 |
$43K |
| 92002 |
|
810 |
798 |
$43K |
| 92004 |
|
427 |
386 |
$34K |
| S0580 |
Polycarb lens |
3,001 |
2,724 |
$29K |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
69 |
59 |
$7K |
| V2300 |
Lens sphere trifocal 4.00d |
45 |
43 |
$4K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
51 |
43 |
$3K |
| V2755 |
Uv lens/es |
113 |
109 |
$3K |
| 99215 |
Prolong outpt/office vis |
57 |
49 |
$2K |
| 99214 |
|
96 |
78 |
$2K |
| V2745 |
Tint, any color/solid/grad |
87 |
84 |
$2K |
| 92250 |
|
39 |
34 |
$679.50 |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
12 |
12 |
$524.88 |
| 92133 |
|
30 |
26 |
$246.00 |
| 92020 |
|
17 |
13 |
$112.01 |