| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
16,213 |
14,266 |
$628K |
| 92014 |
|
1,122 |
1,092 |
$70K |
| 92340 |
|
16,036 |
14,216 |
$47K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,795 |
1,505 |
$40K |
| 92004 |
|
642 |
627 |
$38K |
| V2500 |
Contact lens pmma spherical |
328 |
323 |
$30K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
10,673 |
8,992 |
$27K |
| V2100 |
Lens spher single plano 4.00 |
4,389 |
3,752 |
$11K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
1,421 |
1,197 |
$4K |
| 92341 |
|
437 |
313 |
$4K |
| V2200 |
Lens spher bifoc plano 4.00d |
241 |
231 |
$3K |
| V2107 |
Spherocylinder 4.25d/12-2d |
901 |
767 |
$3K |
| 92015 |
|
2,052 |
2,001 |
$475.00 |
| V2300 |
Lens sphere trifocal 4.00d |
12 |
12 |
$417.00 |
| 2022F |
|
1,112 |
1,089 |
$415.05 |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
14 |
12 |
$230.00 |
| V2799 |
Misc vision item or service |
94 |
89 |
$0.00 |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
13 |
12 |
$0.00 |
| V2744 |
Tint photochromatic lens/es |
12 |
12 |
$0.00 |
| V2025 |
Eyeglasses delux frames |
132 |
122 |
$0.00 |
| V2750 |
Anti-reflective coating |
734 |
641 |
$-203.50 |
| V2784 |
Lens polycarb or equal |
2,710 |
2,313 |
$-268.50 |