| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
3,269 |
3,100 |
$295K |
| 92004 |
|
1,438 |
1,360 |
$157K |
| V2410 |
Lens variab asphericity sing |
1,322 |
573 |
$95K |
| V2020 |
Vision svcs frames purchases |
1,806 |
1,570 |
$75K |
| V2784 |
Lens polycarb or equal |
3,727 |
1,609 |
$47K |
| V2750 |
Anti-reflective coating |
3,182 |
1,393 |
$44K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,585 |
833 |
$40K |
| 92340 |
|
1,785 |
1,554 |
$35K |
| 92310 |
|
673 |
649 |
$12K |
| 99213 |
|
205 |
178 |
$10K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
239 |
148 |
$7K |
| V2100 |
Lens spher single plano 4.00 |
139 |
65 |
$3K |
| V2521 |
Cntct lens hydrophilic toric |
26 |
14 |
$2K |
| 92015 |
|
4,738 |
4,488 |
$2K |
| V2107 |
Spherocylinder 4.25d/12-2d |
29 |
12 |
$876.82 |
| V2745 |
Tint, any color/solid/grad |
30 |
14 |
$153.16 |