| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
14,413 |
12,351 |
$216K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
12,617 |
7,346 |
$130K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
3,940 |
2,250 |
$125K |
| 99211 |
|
10,315 |
9,289 |
$119K |
| 92014 |
|
303 |
272 |
$19K |
| V2100 |
Lens spher single plano 4.00 |
1,644 |
1,229 |
$18K |
| 92340 |
|
1,499 |
1,163 |
$14K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
1,330 |
895 |
$14K |
| V2107 |
Spherocylinder 4.25d/12-2d |
722 |
495 |
$9K |
| 92004 |
|
99 |
93 |
$8K |
| V2799 |
Misc vision item or service |
320 |
290 |
$5K |
| 92341 |
|
123 |
105 |
$1K |
| V2781 |
Progressive lens per lens |
35 |
28 |
$995.10 |
| V2299 |
Lens bifocal speciality |
19 |
12 |
$718.06 |
| V2744 |
Tint photochromatic lens/es |
16 |
13 |
$29.40 |