| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
29,939 |
29,643 |
$2.90M |
| 92004 |
|
14,854 |
14,749 |
$1.65M |
| V2020 |
Vision svcs frames purchases |
42,289 |
41,691 |
$1.55M |
| 92340 |
|
40,699 |
40,143 |
$956K |
| V2784 |
Lens polycarb or equal |
31,913 |
31,413 |
$798K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
24,074 |
23,758 |
$630K |
| V2100 |
Lens spher single plano 4.00 |
11,025 |
10,891 |
$359K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
10,206 |
10,032 |
$269K |
| 92012 |
|
2,708 |
2,706 |
$198K |
| 92015 |
|
37,792 |
37,400 |
$176K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
2,407 |
2,375 |
$68K |
| V2025 |
Eyeglasses delux frames |
2,169 |
2,166 |
$51K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
261 |
258 |
$6K |
| V2107 |
Spherocylinder 4.25d/12-2d |
320 |
315 |
$5K |
| 99211 |
|
52 |
52 |
$935.40 |
| V2200 |
Lens spher bifoc plano 4.00d |
17 |
14 |
$575.01 |
| V2410 |
Lens variab asphericity sing |
2,496 |
2,484 |
$0.00 |