| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Lens variab asphericity sing |
4,810 |
2,137 |
$763K |
| V2020 |
Vision svcs frames purchases |
6,999 |
3,114 |
$290K |
| V2755 |
Uv lens/es |
7,002 |
3,117 |
$233K |
| V2750 |
Anti-reflective coating |
6,501 |
2,859 |
$174K |
| V2430 |
Lens variable asphericity bi |
928 |
348 |
$153K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
3,342 |
1,473 |
$151K |
| V2781 |
Progressive lens per lens |
926 |
348 |
$119K |
| V2784 |
Lens polycarb or equal |
6,396 |
2,861 |
$102K |
| V2745 |
Tint, any color/solid/grad |
2,989 |
2,443 |
$32K |
| V2100 |
Lens spher single plano 4.00 |
511 |
238 |
$20K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
288 |
123 |
$14K |
| 92340 |
|
48 |
46 |
$1K |