| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
1,935 |
1,871 |
$146K |
| V2020 |
Frames, purchases |
3,317 |
3,166 |
$86K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,655 |
2,067 |
$69K |
| 92004 |
|
638 |
624 |
$61K |
| 92340 |
|
2,555 |
2,469 |
$54K |
| 92015 |
|
3,137 |
3,040 |
$37K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,872 |
1,444 |
$36K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
343 |
264 |
$14K |
| 92341 |
|
505 |
482 |
$13K |
| 92012 |
|
60 |
55 |
$3K |