| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
30,941 |
30,122 |
$2.66M |
| 92004 |
|
19,809 |
19,522 |
$1.95M |
| 92340 |
|
20,905 |
20,675 |
$764K |
| V2020 |
Vision svcs frames purchases |
30,380 |
29,980 |
$692K |
| 92250 |
|
11,256 |
11,087 |
$662K |
| V2784 |
Lens polycarb or equal |
22,715 |
22,441 |
$348K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
16,691 |
15,447 |
$337K |
| 92133 |
|
8,321 |
8,184 |
$288K |
| 92015 |
|
33,669 |
33,033 |
$165K |
| V2100 |
Lens spher single plano 4.00 |
7,667 |
7,617 |
$162K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
4,263 |
4,001 |
$103K |
| 92012 |
|
1,412 |
1,242 |
$89K |
| 92083 |
|
1,546 |
1,523 |
$69K |
| 99214 |
|
1,175 |
1,135 |
$62K |
| 99213 |
|
1,433 |
1,346 |
$56K |
| 76514 |
|
2,463 |
2,432 |
$26K |
| 92134 |
|
1,005 |
967 |
$24K |
| 92341 |
|
446 |
436 |
$17K |
| 99203 |
|
175 |
175 |
$17K |
| V2200 |
Lens spher bifoc plano 4.00d |
382 |
375 |
$13K |
| 99204 |
|
65 |
65 |
$8K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
453 |
356 |
$8K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
301 |
273 |
$8K |
| 92285 |
|
776 |
762 |
$8K |
| 66984 |
|
49 |
43 |
$5K |
| 68761 |
|
23 |
23 |
$2K |
| 83861 |
|
69 |
54 |
$2K |
| 92283 |
|
27 |
26 |
$815.12 |
| 92002 |
|
12 |
12 |
$691.26 |
| V2107 |
Spherocylinder 4.25d/12-2d |
33 |
30 |
$539.76 |
| V2299 |
Lens bifocal speciality |
12 |
12 |
$452.40 |
| V2744 |
Tint photochromatic lens/es |
154 |
147 |
$240.00 |
| V2781 |
Progressive lens per lens |
12 |
12 |
$0.00 |
| V2750 |
Anti-reflective coating |
256 |
255 |
$0.00 |