| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
240,254 |
235,311 |
$5.16M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
148,944 |
146,083 |
$2.40M |
| V2784 |
Lens polycarb or equal |
224,989 |
220,816 |
$1.57M |
| V2025 |
Eyeglasses delux frames |
19,565 |
19,228 |
$980K |
| V2100 |
Lens spher single plano 4.00 |
60,967 |
59,777 |
$896K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
42,984 |
42,274 |
$716K |
| V2410 |
Lens variab asphericity sing |
10,442 |
10,278 |
$579K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
7,972 |
7,840 |
$575K |
| V2107 |
Spherocylinder 4.25d/12-2d |
14,551 |
13,973 |
$244K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
11,399 |
11,217 |
$243K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
8,202 |
8,003 |
$166K |
| V2200 |
Lens spher bifoc plano 4.00d |
6,313 |
6,204 |
$130K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
5,513 |
5,389 |
$98K |
| V2121 |
Lenticular lens, single |
2,037 |
2,001 |
$76K |
| V2101 |
Single visn sphere 4.12-7.00 |
3,339 |
3,261 |
$50K |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
1,722 |
1,681 |
$49K |
| V2109 |
Spherocylinder 4.25d/4.25-6d |
1,805 |
1,765 |
$39K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
1,392 |
1,362 |
$28K |
| V2112 |
Spherocylindr 7.25d/2.25-4d |
965 |
946 |
$27K |
| V2430 |
Lens variable asphericity bi |
311 |
306 |
$21K |
| V2207 |
Lens sphcy bifocal 4.25-7d/. |
838 |
821 |
$17K |
| V2106 |
Spherocylinder 4.00d/>6.00d |
460 |
452 |
$12K |
| V2114 |
Spherocylinder over 12.00d |
56 |
56 |
$3K |
| 92340 |
|
56 |
56 |
$3K |
| V2715 |
Prism lens/es |
1,187 |
1,134 |
$2K |
| V2102 |
Singl visn sphere 7.12-20.00 |
12 |
12 |
$255.75 |