| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Lens variab asphericity sing |
3,178 |
3,121 |
$189K |
| V2784 |
Lens polycarb or equal |
8,075 |
7,918 |
$171K |
| V2020 |
Vision svcs frames purchases |
8,349 |
8,194 |
$154K |
| 92340 |
|
4,074 |
3,992 |
$85K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,770 |
4,683 |
$77K |
| V2430 |
Lens variable asphericity bi |
518 |
512 |
$48K |
| V2760 |
Scratch resistant coating |
4,484 |
4,374 |
$46K |
| 92341 |
|
859 |
839 |
$22K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
798 |
780 |
$18K |
| V2100 |
Lens spher single plano 4.00 |
425 |
423 |
$6K |
| V2107 |
Spherocylinder 4.25d/12-2d |
183 |
183 |
$3K |
| S0580 |
Polycarb lens |
20 |
20 |
$180.00 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
13 |
12 |
$179.44 |