| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
10,251 |
9,266 |
$683K |
| 92004 |
|
4,865 |
4,452 |
$397K |
| V2020 |
Vision svcs frames purchases |
12,524 |
11,502 |
$296K |
| V2100 |
Lens spher single plano 4.00 |
8,518 |
7,759 |
$205K |
| 92015 |
|
12,710 |
11,701 |
$160K |
| 99211 |
|
6,737 |
6,601 |
$88K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
3,194 |
2,621 |
$72K |
| 92340 |
|
2,043 |
2,014 |
$25K |
| V2025 |
Eyeglasses delux frames |
947 |
682 |
$24K |
| 92250 |
|
877 |
814 |
$21K |
| V2200 |
Lens spher bifoc plano 4.00d |
372 |
299 |
$15K |
| 92012 |
|
171 |
157 |
$6K |
| V2781 |
Progressive lens per lens |
61 |
50 |
$2K |
| V2799 |
Misc vision item or service |
164 |
162 |
$2K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
108 |
104 |
$2K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
15 |
14 |
$1K |
| V2107 |
Spherocylinder 4.25d/12-2d |
16 |
13 |
$351.05 |
| V2744 |
Tint photochromatic lens/es |
26 |
26 |
$254.00 |
| 92341 |
|
12 |
12 |
$148.32 |
| 2025F |
|
28 |
27 |
$0.00 |
| 2022F |
|
14 |
12 |
$0.00 |