| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
25,339 |
24,286 |
$705K |
| 92340 |
|
20,227 |
19,403 |
$398K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
13,769 |
13,204 |
$397K |
| S0580 |
Polycarb lens |
11,028 |
10,577 |
$307K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
4,458 |
4,304 |
$188K |
| 92341 |
|
5,359 |
5,200 |
$123K |
| V2100 |
Lens spher single plano 4.00 |
4,165 |
4,045 |
$96K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
1,392 |
1,358 |
$35K |
| V2107 |
Spherocylinder 4.25d/12-2d |
556 |
537 |
$18K |
| V2200 |
Lens spher bifoc plano 4.00d |
435 |
420 |
$14K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
40 |
37 |
$1K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
14 |
13 |
$660.40 |
| V2744 |
Tint photochromatic lens/es |
13 |
13 |
$288.19 |
| 92370 |
|
29 |
29 |
$184.80 |