| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
30,594 |
28,704 |
$875K |
| 92340 |
|
40,118 |
38,092 |
$826K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
19,169 |
10,974 |
$267K |
| 92341 |
|
10,652 |
9,680 |
$203K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
5,929 |
3,197 |
$114K |
| V2100 |
Lens spher single plano 4.00 |
6,809 |
4,283 |
$106K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
1,992 |
1,306 |
$28K |
| V2114 |
Spherocylinder over 12.00d |
552 |
308 |
$20K |
| V2200 |
Lens spher bifoc plano 4.00d |
983 |
686 |
$18K |
| V2107 |
Spherocylinder 4.25d/12-2d |
1,056 |
693 |
$17K |
| V2700 |
Balance lens |
177 |
143 |
$3K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
18 |
13 |
$367.74 |
| V2101 |
Single visn sphere 4.12-7.00 |
17 |
12 |
$338.30 |
| 92342 |
|
12 |
12 |
$304.52 |
| V2750 |
Anti-reflective coating |
68 |
68 |
$91.50 |