| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
18,739 |
16,312 |
$264K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
7,743 |
6,591 |
$157K |
| 99211 |
|
11,877 |
11,470 |
$150K |
| V2100 |
Lens spher single plano 4.00 |
6,735 |
6,137 |
$123K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,245 |
1,027 |
$66K |
| V2200 |
Lens spher bifoc plano 4.00d |
717 |
655 |
$36K |
| V2784 |
Lens polycarb or equal |
2,135 |
1,840 |
$25K |
| 92340 |
|
3,518 |
1,857 |
$21K |
| V2107 |
Spherocylinder 4.25d/12-2d |
879 |
750 |
$16K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
867 |
723 |
$13K |
| V2101 |
Single visn sphere 4.12-7.00 |
340 |
327 |
$8K |
| V2781 |
Progressive lens per lens |
105 |
82 |
$4K |
| V2799 |
Misc vision item or service |
285 |
256 |
$2K |
| V2299 |
Lens bifocal speciality |
12 |
12 |
$700.64 |
| V2102 |
Singl visn sphere 7.12-20.00 |
12 |
12 |
$300.50 |
| S0580 |
Polycarb lens |
14 |
13 |
$27.00 |