| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
1,721,869 |
1,430,058 |
$15.90M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,155,628 |
964,810 |
$9.39M |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
242,277 |
197,639 |
$2.61M |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
221,195 |
182,218 |
$1.75M |
| S0580 |
Polycarb lens |
189,931 |
157,731 |
$1.64M |
| V2107 |
Spherocylinder 4.25d/12-2d |
138,214 |
115,330 |
$1.04M |
| V2710 |
Glass/plastic slab off prism |
16,196 |
12,730 |
$606K |
| V2780 |
Oversize lens/es |
238,376 |
191,196 |
$596K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
52,293 |
42,935 |
$480K |
| V2730 |
Special base curve |
26,569 |
22,734 |
$405K |
| V2410 |
Lens variab asphericity sing |
18,489 |
15,228 |
$398K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
39,220 |
32,274 |
$308K |
| S0581 |
Nonstnd lens |
19,669 |
16,161 |
$282K |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
22,339 |
18,491 |
$223K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
21,369 |
17,315 |
$190K |
| V2207 |
Lens sphcy bifocal 4.25-7d/. |
13,528 |
10,996 |
$122K |
| V2112 |
Spherocylindr 7.25d/2.25-4d |
9,586 |
7,917 |
$99K |
| V2109 |
Spherocylinder 4.25d/4.25-6d |
10,221 |
8,433 |
$93K |
| V2114 |
Spherocylinder over 12.00d |
3,393 |
2,844 |
$67K |
| V2106 |
Spherocylinder 4.00d/>6.00d |
3,584 |
2,913 |
$42K |
| V2115 |
Lens lenticular bifocal |
4,036 |
3,648 |
$42K |
| V2715 |
Prism lens/es |
8,502 |
7,165 |
$35K |
| V2211 |
Lens sphcy bifo 7.25-12/.25- |
2,900 |
2,387 |
$35K |
| V2217 |
|
1,926 |
1,473 |
$34K |
| V2208 |
Lens sphcy bifocal 4.25-7/2. |
2,897 |
2,344 |
$26K |
| V2205 |
Lens sphcy bifocal 4.00d/4.2 |
2,314 |
1,839 |
$23K |
| V2113 |
Spherocylindr 7.25d/4.25-6d |
1,794 |
1,484 |
$20K |
| V2215 |
Lens lenticular bifocal |
1,005 |
936 |
$13K |
| V2220 |
Lens bifocal add over 3.25d |
1,517 |
1,232 |
$10K |
| V2700 |
Balance lens |
1,941 |
1,203 |
$9K |
| V2212 |
Lens sphcyl bifo 7.25-12/2.2 |
476 |
423 |
$6K |
| V2303 |
Lens sphcy trifocal 4.0/.12- |
138 |
123 |
$2K |
| V2110 |
Spherocylinder 4.25d/over 6d |
93 |
67 |
$1K |
| V2214 |
Lens sphcyl bifocal over 12. |
43 |
37 |
$816.49 |
| V2209 |
Lens sphcy bifocal 4.25-7/4. |
40 |
40 |
$481.05 |
| V2219 |
Lens bifocal seg width over |
88 |
88 |
$151.00 |