| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Lens spher single plano 4.00 |
36,721 |
36,463 |
$1.20M |
| V2020 |
Vision svcs frames purchases |
23,242 |
23,053 |
$940K |
| 92004 |
|
19,123 |
19,103 |
$727K |
| 92014 |
|
18,291 |
18,260 |
$697K |
| V2200 |
Lens spher bifoc plano 4.00d |
5,292 |
5,274 |
$277K |
| 92015 |
|
21,423 |
21,401 |
$52K |
| 92002 |
|
613 |
612 |
$18K |
| 92012 |
|
367 |
366 |
$12K |
| V2300 |
Lens sphere trifocal 4.00d |
49 |
49 |
$5K |
| V2760 |
Scratch resistant coating |
9,971 |
9,780 |
$2K |
| V2750 |
Anti-reflective coating |
8,554 |
8,435 |
$189.70 |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
22 |
20 |
$110.25 |
| V2797 |
Vis item/svc in other code |
1,295 |
1,287 |
$15.75 |
| 99199 |
|
1,798 |
1,797 |
$0.00 |
| V2745 |
Tint, any color/solid/grad |
2,991 |
2,911 |
$0.00 |
| V2499 |
Variable asphericity lens |
137 |
136 |
$0.00 |
| V2025 |
Eyeglasses delux frames |
17,415 |
17,347 |
$0.00 |
| V2410 |
Lens variab asphericity sing |
1,653 |
1,585 |
$0.00 |
| V2762 |
Polarization, any lens |
115 |
115 |
$0.00 |
| 92225 |
|
102 |
102 |
$0.00 |
| 92081 |
|
436 |
436 |
$0.00 |
| S0518 |
Sunglass frames |
730 |
718 |
$0.00 |
| 2021F |
|
13 |
13 |
$0.00 |
| 2022F |
|
12 |
12 |
$0.00 |
| V2781 |
Progressive lens per lens |
482 |
478 |
$0.00 |
| 92250 |
|
101 |
101 |
$0.00 |
| V2744 |
Tint photochromatic lens/es |
1,592 |
1,574 |
$0.00 |
| V2755 |
Uv lens/es |
10,994 |
10,778 |
$0.00 |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
5,263 |
5,194 |
$0.00 |
| V2799 |
Misc vision item or service |
1,378 |
1,369 |
$0.00 |
| V2784 |
Lens polycarb or equal |
17,466 |
17,285 |
$0.00 |
| 92310 |
|
72 |
72 |
$0.00 |
| V2702 |
Deluxe lens feature |
266 |
265 |
$0.00 |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
280 |
280 |
$0.00 |
| 3072F |
|
330 |
330 |
$0.00 |
| 92082 |
|
60 |
60 |
$0.00 |