| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
7,967 |
7,581 |
$53K |
| V2020 |
Vision svcs frames purchases |
14,344 |
13,506 |
$38K |
| 92340 |
|
2,203 |
2,015 |
$30K |
| V2100 |
Lens spher single plano 4.00 |
19,549 |
10,941 |
$28K |
| 92004 |
|
4,907 |
4,744 |
$22K |
| V2200 |
Lens spher bifoc plano 4.00d |
2,435 |
1,451 |
$6K |
| 92015 |
|
1,493 |
1,366 |
$5K |
| 92342 |
|
298 |
265 |
$4K |
| V2500 |
Contact lens pmma spherical |
94 |
84 |
$4K |
| V2300 |
Lens sphere trifocal 4.00d |
791 |
506 |
$3K |
| 92310 |
|
481 |
459 |
$2K |
| 92341 |
|
130 |
115 |
$2K |
| 92250 |
|
2,070 |
1,886 |
$265.69 |
| V2784 |
Lens polycarb or equal |
4,381 |
2,252 |
$96.52 |
| S0500 |
Dispos cont lens |
585 |
580 |
$0.00 |
| V2744 |
Tint photochromatic lens/es |
617 |
337 |
$0.00 |
| V2799 |
Misc vision item or service |
181 |
124 |
$0.00 |
| V2781 |
Progressive lens per lens |
790 |
554 |
$0.00 |
| V2755 |
Uv lens/es |
818 |
380 |
$0.00 |
| V2750 |
Anti-reflective coating |
2,545 |
1,315 |
$0.00 |
| V2797 |
Vis item/svc in other code |
27 |
26 |
$0.00 |