| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 68761 |
|
7,257 |
2,910 |
$858K |
| 92004 |
|
13,965 |
13,874 |
$526K |
| V2020 |
Frames, purchases |
20,155 |
20,018 |
$424K |
| 92340 |
|
14,553 |
14,453 |
$326K |
| 99204 |
|
3,689 |
3,671 |
$227K |
| 92015 |
|
22,805 |
22,655 |
$170K |
| 92341 |
|
4,702 |
4,675 |
$146K |
| 92014 |
|
2,598 |
2,594 |
$93K |
| 92250 |
|
2,413 |
2,398 |
$87K |
| 99213 |
|
1,935 |
1,885 |
$43K |
| 99214 |
|
1,031 |
1,023 |
$34K |
| 92225 |
|
342 |
328 |
$28K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
632 |
625 |
$22K |
| 92202 |
|
1,306 |
1,296 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,138 |
2,115 |
$17K |
| 92273 |
|
109 |
107 |
$12K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
245 |
241 |
$8K |
| V2750 |
Anti-reflective coating, per lens |
202 |
198 |
$6K |
| V2744 |
Tint, photochromatic, per lens |
72 |
71 |
$2K |
| 92201 |
|
14 |
14 |
$1K |
| 3072F |
|
13 |
13 |
$0.00 |