| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
5,559 |
3,951 |
$822K |
| V2025 |
Eyeglasses delux frames |
10,403 |
8,573 |
$658K |
| 92014 |
|
7,271 |
6,675 |
$486K |
| 92004 |
|
5,308 |
4,965 |
$443K |
| V2020 |
Vision svcs frames purchases |
13,000 |
10,620 |
$234K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
13,932 |
11,113 |
$232K |
| V2760 |
Scratch resistant coating |
14,572 |
11,061 |
$223K |
| 99211 |
|
17,044 |
14,279 |
$206K |
| 92340 |
|
5,764 |
3,990 |
$62K |
| V2781 |
Progressive lens per lens |
433 |
400 |
$50K |
| V2715 |
Prism lens/es |
4,239 |
3,091 |
$43K |
| V2100 |
Lens spher single plano 4.00 |
2,610 |
2,127 |
$42K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
1,726 |
1,316 |
$27K |
| V2520 |
Contact lens hydrophilic |
31 |
30 |
$23K |
| V2107 |
Spherocylinder 4.25d/12-2d |
1,199 |
896 |
$22K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
278 |
251 |
$15K |
| V2730 |
Special base curve |
608 |
479 |
$12K |
| V2745 |
Tint, any color/solid/grad |
2,573 |
2,325 |
$11K |
| 92012 |
|
134 |
119 |
$6K |
| V2784 |
Lens polycarb or equal |
69 |
55 |
$3K |
| V2106 |
Spherocylinder 4.00d/>6.00d |
34 |
33 |
$2K |
| V2799 |
Misc vision item or service |
133 |
115 |
$1K |
| V2744 |
Tint photochromatic lens/es |
108 |
99 |
$1K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
16 |
13 |
$270.20 |
| V2756 |
Eye glass case |
15 |
13 |
$50.40 |
| V2755 |
Uv lens/es |
46 |
43 |
$0.00 |
| V2780 |
Oversize lens/es |
28 |
24 |
$0.00 |
| 92015 |
|
12 |
12 |
$0.00 |