| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
18,172 |
17,218 |
$34K |
| 92012 |
|
8,436 |
7,937 |
$33K |
| V2100 |
Lens spher single plano 4.00 |
13,258 |
12,598 |
$31K |
| 92002 |
|
4,926 |
4,663 |
$27K |
| V2781 |
Progressive lens per lens |
2,185 |
2,068 |
$12K |
| V2299 |
Lens bifocal speciality |
2,195 |
2,078 |
$10K |
| V2784 |
Lens polycarb or equal |
10,344 |
9,781 |
$10K |
| V2200 |
Lens spher bifoc plano 4.00d |
615 |
577 |
$3K |
| 92014 |
|
596 |
593 |
$3K |
| 92004 |
|
396 |
392 |
$2K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
605 |
556 |
$1K |
| 92310 |
|
24 |
13 |
$152.00 |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
21 |
14 |
$37.70 |
| V2744 |
Tint photochromatic lens/es |
1,362 |
1,266 |
$0.00 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
13 |
13 |
$0.00 |
| V2750 |
Anti-reflective coating |
688 |
647 |
$0.00 |
| V2745 |
Tint, any color/solid/grad |
14 |
14 |
$0.00 |
| 92015 |
|
43 |
35 |
$0.00 |