| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
80,795 |
78,370 |
$310K |
| 92340 |
|
91,255 |
89,075 |
$307K |
| 92004 |
|
4,846 |
4,739 |
$160K |
| 92341 |
|
12,587 |
12,324 |
$123K |
| 92015 |
|
87,708 |
85,081 |
$103K |
| V2020 |
Vision svcs frames purchases |
97,804 |
95,219 |
$99K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
84,159 |
49,988 |
$75K |
| V2784 |
Lens polycarb or equal |
52,965 |
51,792 |
$25K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
11,940 |
6,845 |
$17K |
| V2100 |
Lens spher single plano 4.00 |
37,063 |
22,382 |
$6K |
| V2200 |
Lens spher bifoc plano 4.00d |
2,257 |
1,564 |
$2K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
14,295 |
9,375 |
$2K |
| 92342 |
|
846 |
830 |
$2K |
| V2107 |
Spherocylinder 4.25d/12-2d |
9,499 |
5,974 |
$2K |
| V2025 |
Eyeglasses delux frames |
797 |
761 |
$2K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
1,874 |
1,312 |
$515.01 |
| V2303 |
Lens sphcy trifocal 4.0/.12- |
886 |
490 |
$505.18 |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
72 |
54 |
$385.20 |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
2,880 |
1,935 |
$360.66 |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
345 |
218 |
$322.90 |
| V2101 |
Single visn sphere 4.12-7.00 |
873 |
614 |
$185.08 |
| 92310 |
|
14 |
14 |
$0.00 |
| 2023F |
|
12 |
12 |
$0.00 |
| V2780 |
Oversize lens/es |
28 |
28 |
$0.00 |