| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
1,329 |
898 |
$64K |
| 92015 |
|
2,830 |
2,002 |
$54K |
| 92012 |
|
699 |
343 |
$47K |
| 92083 |
|
1,062 |
834 |
$34K |
| V2020 |
Frames, purchases |
954 |
772 |
$34K |
| 92020 |
|
1,092 |
854 |
$15K |
| 92250 |
|
645 |
600 |
$10K |
| 92004 |
|
217 |
214 |
$7K |
| 92014 |
|
192 |
192 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
436 |
241 |
$4K |
| V2199 |
Not otherwise classified, single vision lens |
146 |
146 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
179 |
179 |
$0.00 |
| 3072F |
|
507 |
506 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
472 |
472 |
$0.00 |
| V2781 |
Progressive lens, per lens |
13 |
13 |
$0.00 |