| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
3,154 |
2,350 |
$524K |
| 92004 |
|
2,141 |
2,025 |
$257K |
| V2020 |
Frames, purchases |
3,349 |
2,483 |
$154K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,258 |
2,423 |
$139K |
| 92014 |
|
1,002 |
938 |
$104K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,942 |
1,423 |
$99K |
| V2750 |
Anti-reflective coating, per lens |
3,193 |
2,377 |
$88K |
| 92340 |
|
3,336 |
2,476 |
$68K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
783 |
601 |
$42K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
213 |
164 |
$10K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
57 |
53 |
$3K |
| 92015 |
|
3,175 |
2,960 |
$2K |
| 99212 |
|
58 |
57 |
$2K |