| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
32,818 |
31,088 |
$939K |
| 92340 |
|
29,118 |
27,353 |
$583K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
19,042 |
18,057 |
$551K |
| S0580 |
Polycarb lens |
18,632 |
17,519 |
$526K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
5,856 |
5,662 |
$247K |
| 92341 |
|
6,820 |
6,573 |
$157K |
| V2100 |
Lens spher single plano 4.00 |
5,738 |
5,423 |
$127K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
3,672 |
3,455 |
$88K |
| V2107 |
Spherocylinder 4.25d/12-2d |
2,330 |
2,204 |
$77K |
| 92370 |
|
10,696 |
10,126 |
$67K |
| V2200 |
Lens spher bifoc plano 4.00d |
896 |
871 |
$27K |
| V2025 |
Eyeglasses delux frames |
111 |
102 |
$10K |
| V2730 |
Special base curve |
652 |
582 |
$8K |
| 92342 |
|
147 |
144 |
$5K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
173 |
166 |
$5K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
145 |
141 |
$5K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
41 |
41 |
$1K |
| V2780 |
Oversize lens/es |
84 |
81 |
$1K |
| V2101 |
Single visn sphere 4.12-7.00 |
13 |
12 |
$238.65 |