| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
18,553 |
18,483 |
$1.08M |
| 92250 |
|
17,762 |
17,675 |
$802K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
2,726 |
2,714 |
$678K |
| 92004 |
|
9,643 |
9,609 |
$665K |
| 92060 |
|
10,896 |
10,853 |
$405K |
| 92012 |
|
8,869 |
8,621 |
$364K |
| V2410 |
Lens variab asphericity sing |
6,173 |
6,150 |
$259K |
| V2100 |
Lens spher single plano 4.00 |
17,098 |
11,086 |
$232K |
| V2020 |
Vision svcs frames purchases |
21,822 |
21,638 |
$230K |
| 99213 |
|
5,857 |
5,304 |
$229K |
| 76512 |
|
2,659 |
2,652 |
$215K |
| 92015 |
|
18,409 |
18,270 |
$184K |
| 92340 |
|
11,795 |
11,729 |
$159K |
| 92310 |
|
1,235 |
1,193 |
$156K |
| 92133 |
|
2,871 |
2,863 |
$84K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
8,873 |
7,818 |
$79K |
| 92025 |
|
3,009 |
2,997 |
$68K |
| 92225 |
|
2,474 |
2,351 |
$66K |
| 99204 |
|
862 |
857 |
$66K |
| V2200 |
Lens spher bifoc plano 4.00d |
2,922 |
1,738 |
$65K |
| 92226 |
|
1,862 |
1,775 |
$52K |
| 92285 |
|
2,324 |
2,308 |
$48K |
| 99214 |
|
835 |
831 |
$45K |
| 92273 |
|
421 |
420 |
$41K |
| V2784 |
Lens polycarb or equal |
13,666 |
7,353 |
$30K |
| 92202 |
|
2,034 |
2,025 |
$30K |
| V2430 |
Lens variable asphericity bi |
445 |
440 |
$25K |
| 92083 |
|
458 |
457 |
$22K |
| 92341 |
|
979 |
971 |
$17K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
934 |
770 |
$17K |
| 92134 |
|
443 |
443 |
$11K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
845 |
616 |
$6K |
| 99212 |
|
37 |
37 |
$846.60 |
| 92020 |
|
55 |
55 |
$751.35 |
| 68801 |
|
13 |
13 |
$532.80 |
| 92286 |
|
38 |
38 |
$291.01 |
| V2102 |
Singl visn sphere 7.12-20.00 |
12 |
12 |
$227.70 |
| 2023F |
|
31 |
31 |
$0.00 |
| V2755 |
Uv lens/es |
194 |
97 |
$0.00 |
| 3072F |
|
86 |
85 |
$0.00 |
| 2022F |
|
173 |
170 |
$0.00 |
| 2024F |
|
16 |
16 |
$0.00 |