| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2219 |
Lens bifocal seg width over |
1,377 |
1,189 |
$107K |
| V2303 |
Lens sphcy trifocal 4.0/.12- |
841 |
729 |
$92K |
| V2430 |
Lens variable asphericity bi |
1,432 |
1,243 |
$80K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
134 |
119 |
$40K |
| V2020 |
Vision svcs frames purchases |
4,198 |
3,797 |
$29K |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
430 |
368 |
$25K |
| 92341 |
|
1,308 |
1,166 |
$23K |
| V2319 |
Lens trifocal seg width > 28 |
439 |
392 |
$21K |
| 92340 |
|
1,306 |
1,190 |
$18K |
| S0580 |
Polycarb lens |
804 |
725 |
$12K |
| 92342 |
|
551 |
462 |
$10K |
| V2410 |
Lens variab asphericity sing |
265 |
226 |
$10K |
| V2784 |
Lens polycarb or equal |
309 |
216 |
$7K |
| 92004 |
|
142 |
130 |
$7K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
305 |
254 |
$6K |
| V2100 |
Lens spher single plano 4.00 |
275 |
140 |
$5K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
451 |
382 |
$4K |
| V2200 |
Lens spher bifoc plano 4.00d |
154 |
71 |
$4K |
| 92015 |
|
38 |
38 |
$528.00 |
| 92226 |
|
14 |
14 |
$378.00 |
| V2755 |
Uv lens/es |
238 |
117 |
$0.00 |