| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
40,751 |
29,835 |
$1.58M |
| V2784 |
Lens polycarb or equal |
30,003 |
21,992 |
$961K |
| 92340 |
|
40,909 |
29,723 |
$934K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
19,486 |
12,805 |
$675K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
13,679 |
7,938 |
$545K |
| 92014 |
|
3,078 |
2,763 |
$282K |
| V2025 |
Eyeglasses delux frames |
3,056 |
2,421 |
$276K |
| 92004 |
|
2,372 |
2,172 |
$263K |
| V2100 |
Lens spher single plano 4.00 |
5,147 |
3,620 |
$186K |
| V2107 |
Spherocylinder 4.25d/12-2d |
4,555 |
2,664 |
$178K |
| V2755 |
Uv lens/es |
5,811 |
4,171 |
$153K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
3,302 |
1,865 |
$143K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
2,510 |
1,426 |
$103K |
| V2109 |
Spherocylinder 4.25d/4.25-6d |
496 |
255 |
$21K |
| V2219 |
Lens bifocal seg width over |
134 |
107 |
$13K |
| 92015 |
|
5,648 |
5,072 |
$8K |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
197 |
102 |
$8K |
| V2112 |
Spherocylindr 7.25d/2.25-4d |
140 |
66 |
$7K |
| 92341 |
|
235 |
174 |
$5K |
| V2114 |
Spherocylinder over 12.00d |
27 |
12 |
$2K |
| V2744 |
Tint photochromatic lens/es |
810 |
676 |
$99.04 |