| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Lens variab asphericity sing |
11,062 |
8,897 |
$1.65M |
| V2025 |
Eyeglasses delux frames |
7,944 |
5,920 |
$720K |
| 92014 |
|
6,207 |
5,792 |
$620K |
| 92004 |
|
4,346 |
4,027 |
$503K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
8,742 |
7,105 |
$377K |
| V2784 |
Lens polycarb or equal |
13,600 |
10,980 |
$365K |
| V2750 |
Anti-reflective coating |
13,136 |
10,539 |
$333K |
| 92340 |
|
13,672 |
11,069 |
$254K |
| V2020 |
Vision svcs frames purchases |
5,415 |
4,947 |
$193K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
2,837 |
2,278 |
$136K |
| V2100 |
Lens spher single plano 4.00 |
1,428 |
1,236 |
$54K |
| 92310 |
|
192 |
184 |
$25K |
| 99211 |
|
1,300 |
1,271 |
$23K |
| 92015 |
|
11,291 |
10,498 |
$20K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
287 |
250 |
$15K |
| V2521 |
Cntct lens hydrophilic toric |
43 |
24 |
$6K |
| 99212 |
|
135 |
126 |
$5K |
| V2520 |
Contact lens hydrophilic |
23 |
14 |
$2K |
| V2745 |
Tint, any color/solid/grad |
82 |
80 |
$2K |
| V2107 |
Spherocylinder 4.25d/12-2d |
32 |
26 |
$1K |