| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
4,229 |
3,902 |
$238K |
| 92004 |
|
3,123 |
2,893 |
$233K |
| V2745 |
Tint, any color/solid/grad |
2,205 |
1,934 |
$146K |
| 92340 |
|
8,883 |
7,982 |
$142K |
| V2750 |
Anti-reflective coating |
1,934 |
1,794 |
$131K |
| V2410 |
Lens variab asphericity sing |
1,642 |
1,286 |
$109K |
| V2020 |
Vision svcs frames purchases |
8,189 |
7,398 |
$103K |
| V2784 |
Lens polycarb or equal |
8,142 |
7,346 |
$72K |
| 92015 |
|
7,607 |
6,989 |
$61K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
9,990 |
5,548 |
$47K |
| V2100 |
Lens spher single plano 4.00 |
4,047 |
2,590 |
$16K |
| S0620 |
Routine ophthalmological exa |
192 |
182 |
$6K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
304 |
188 |
$2K |
| 99212 |
|
56 |
52 |
$1K |
| V2107 |
Spherocylinder 4.25d/12-2d |
48 |
28 |
$369.80 |
| V2799 |
Misc vision item or service |
34 |
31 |
$0.00 |