| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
|
33,826 |
27,999 |
$954K |
| V2020 |
Vision svcs frames purchases |
26,081 |
21,052 |
$165K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
11,661 |
9,194 |
$157K |
| V2100 |
Lens spher single plano 4.00 |
7,016 |
5,810 |
$155K |
| 92012 |
|
2,153 |
2,135 |
$97K |
| V2784 |
Lens polycarb or equal |
10,214 |
7,991 |
$87K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
2,660 |
2,218 |
$53K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
3,802 |
2,945 |
$47K |
| V2200 |
Lens spher bifoc plano 4.00d |
799 |
672 |
$22K |
| V2107 |
Spherocylinder 4.25d/12-2d |
1,297 |
1,008 |
$17K |
| 92341 |
|
519 |
493 |
$13K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
756 |
590 |
$8K |
| 92004 |
|
273 |
262 |
$3K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
254 |
201 |
$3K |
| 92015 |
|
351 |
301 |
$2K |
| V2101 |
Single visn sphere 4.12-7.00 |
182 |
151 |
$2K |
| V2102 |
Singl visn sphere 7.12-20.00 |
30 |
12 |
$770.00 |
| V2025 |
Eyeglasses delux frames |
46 |
41 |
$281.59 |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
14 |
14 |
$88.00 |