| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
20,106 |
17,755 |
$575K |
| S0580 |
Polycarb lens |
20,359 |
18,014 |
$574K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
14,090 |
11,964 |
$460K |
| 92340 |
|
17,451 |
15,251 |
$350K |
| V2799 |
Misc vision item or service |
9,587 |
7,521 |
$346K |
| V2106 |
Spherocylinder 4.00d/>6.00d |
2,217 |
2,166 |
$86K |
| V2200 |
Lens spher bifoc plano 4.00d |
1,606 |
1,528 |
$77K |
| 92341 |
|
2,572 |
2,469 |
$60K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
594 |
582 |
$27K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
537 |
524 |
$14K |
| V2100 |
Lens spher single plano 4.00 |
487 |
483 |
$10K |
| V2107 |
Spherocylinder 4.25d/12-2d |
233 |
229 |
$8K |
| V2206 |
Lens sphcy bifocal 4.00d/ove |
156 |
151 |
$8K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
13 |
13 |
$641.16 |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
16 |
16 |
$597.04 |
| 92371 |
|
93 |
89 |
$541.20 |
| 92370 |
|
25 |
25 |
$158.40 |