| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
974 |
865 |
$187K |
| 92004 |
|
926 |
856 |
$111K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,059 |
937 |
$83K |
| V2020 |
Frames, purchases |
990 |
858 |
$65K |
| V2750 |
Anti-reflective coating, per lens |
1,053 |
932 |
$35K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
527 |
474 |
$33K |
| 92340 |
|
1,104 |
961 |
$27K |
| 99213 |
|
346 |
327 |
$24K |
| 92250 |
|
386 |
374 |
$13K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
178 |
163 |
$12K |
| 92014 |
|
59 |
57 |
$6K |
| 92015 |
|
1,002 |
925 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
51 |
48 |
$4K |