| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Lens variab asphericity sing |
17,440 |
14,125 |
$2.49M |
| 92014 |
|
16,934 |
16,029 |
$1.71M |
| V2020 |
Vision svcs frames purchases |
27,724 |
22,204 |
$1.12M |
| 92004 |
|
6,176 |
5,883 |
$740K |
| V2784 |
Lens polycarb or equal |
25,558 |
20,581 |
$704K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
15,423 |
12,652 |
$647K |
| 92340 |
|
27,063 |
21,766 |
$489K |
| V2750 |
Anti-reflective coating |
9,089 |
7,107 |
$256K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
5,179 |
4,017 |
$249K |
| V2100 |
Lens spher single plano 4.00 |
5,508 |
4,612 |
$220K |
| 99213 |
|
424 |
403 |
$28K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
515 |
390 |
$26K |
| 99212 |
|
476 |
423 |
$19K |
| 92015 |
|
23,728 |
22,495 |
$17K |
| 92012 |
|
187 |
180 |
$13K |
| 99211 |
|
658 |
638 |
$11K |
| V2118 |
Lens aniseikonic single |
185 |
158 |
$11K |
| V2107 |
Spherocylinder 4.25d/12-2d |
217 |
169 |
$9K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
40 |
26 |
$2K |
| V2744 |
Tint photochromatic lens/es |
37 |
36 |
$609.88 |