| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
15,258 |
14,568 |
$1.62M |
| 92014 |
|
13,319 |
12,676 |
$1.17M |
| V2020 |
Vision svcs frames purchases |
29,778 |
27,894 |
$1.07M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
14,471 |
13,590 |
$639K |
| 92015 |
|
32,303 |
30,906 |
$447K |
| V2100 |
Lens spher single plano 4.00 |
3,940 |
3,665 |
$145K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
2,458 |
2,255 |
$114K |
| V2410 |
Lens variab asphericity sing |
627 |
551 |
$104K |
| V2755 |
Uv lens/es |
3,897 |
3,553 |
$103K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
1,196 |
1,119 |
$44K |
| V2784 |
Lens polycarb or equal |
348 |
268 |
$15K |
| 92002 |
|
886 |
886 |
$14K |
| V2200 |
Lens spher bifoc plano 4.00d |
619 |
585 |
$14K |
| V2107 |
Spherocylinder 4.25d/12-2d |
342 |
334 |
$6K |
| 99212 |
|
25 |
18 |
$1K |
| 92310 |
|
16 |
16 |
$405.00 |
| V2750 |
Anti-reflective coating |
52 |
49 |
$280.00 |
| V2101 |
Single visn sphere 4.12-7.00 |
13 |
12 |
$0.00 |
| 92012 |
|
342 |
341 |
$0.00 |