| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
732 |
727 |
$219K |
| 92014 |
|
1,085 |
1,084 |
$50K |
| V2020 |
Vision svcs frames purchases |
2,901 |
2,887 |
$46K |
| V2303 |
Lens sphcy trifocal 4.0/.12- |
375 |
371 |
$42K |
| V2219 |
Lens bifocal seg width over |
533 |
529 |
$42K |
| V2100 |
Lens spher single plano 4.00 |
1,851 |
942 |
$37K |
| 92004 |
|
389 |
389 |
$20K |
| 92340 |
|
1,492 |
1,482 |
$20K |
| V2410 |
Lens variab asphericity sing |
327 |
326 |
$14K |
| V2430 |
Lens variable asphericity bi |
238 |
237 |
$14K |
| 92341 |
|
528 |
524 |
$9K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
876 |
860 |
$9K |
| S0580 |
Polycarb lens |
406 |
403 |
$7K |
| V2500 |
Contact lens pmma spherical |
40 |
40 |
$7K |
| V2784 |
Lens polycarb or equal |
2,167 |
1,145 |
$7K |
| 92015 |
|
433 |
433 |
$5K |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
73 |
72 |
$4K |
| 99215 |
Prolong outpt/office vis |
42 |
42 |
$3K |
| 92250 |
|
34 |
34 |
$2K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
45 |
45 |
$931.50 |
| 92342 |
|
13 |
13 |
$234.00 |
| 2026F |
|
17 |
17 |
$0.00 |