| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
74,211 |
73,157 |
$928K |
| V2784 |
Lens polycarb or equal |
46,330 |
45,479 |
$912K |
| V2744 |
Tint photochromatic lens/es |
12,404 |
12,182 |
$541K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
34,580 |
34,148 |
$509K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
20,909 |
20,550 |
$425K |
| 92340 |
|
19,321 |
19,028 |
$346K |
| V2760 |
Scratch resistant coating |
32,512 |
31,896 |
$314K |
| V2755 |
Uv lens/es |
28,907 |
28,528 |
$259K |
| 92341 |
|
13,693 |
13,318 |
$236K |
| S0580 |
Polycarb lens |
11,941 |
11,885 |
$215K |
| V2100 |
Lens spher single plano 4.00 |
6,262 |
6,182 |
$93K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
3,133 |
3,096 |
$51K |
| V2200 |
Lens spher bifoc plano 4.00d |
2,225 |
2,192 |
$48K |
| V2107 |
Spherocylinder 4.25d/12-2d |
2,957 |
2,917 |
$47K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
544 |
537 |
$39K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
709 |
689 |
$15K |
| V2207 |
Lens sphcy bifocal 4.25-7d/. |
574 |
558 |
$12K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
528 |
522 |
$8K |
| V2520 |
Contact lens hydrophilic |
107 |
104 |
$7K |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
299 |
297 |
$5K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
260 |
256 |
$4K |
| V2599 |
Contact lens/es other type |
16 |
12 |
$1K |
| V2303 |
Lens sphcy trifocal 4.0/.12- |
42 |
42 |
$1K |
| V2521 |
Cntct lens hydrophilic toric |
25 |
25 |
$708.50 |
| V2781 |
Progressive lens per lens |
14 |
14 |
$0.00 |
| V2750 |
Anti-reflective coating |
29 |
29 |
$0.00 |