| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
18,033 |
17,612 |
$1.08M |
| V2784 |
Lens polycarb or equal |
28,995 |
28,355 |
$1.03M |
| 92004 |
|
11,169 |
10,832 |
$947K |
| 92340 |
|
27,273 |
26,724 |
$795K |
| 92015 |
|
25,147 |
24,617 |
$473K |
| V2020 |
Vision svcs frames purchases |
32,869 |
32,122 |
$464K |
| 92065 |
|
7,472 |
3,912 |
$208K |
| V2100 |
Lens spher single plano 4.00 |
9,064 |
8,870 |
$159K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
8,453 |
8,293 |
$142K |
| 99214 |
|
2,260 |
2,012 |
$48K |
| 99213 |
|
2,234 |
1,983 |
$46K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
597 |
589 |
$9K |
| 92083 |
|
533 |
484 |
$9K |
| 92133 |
|
350 |
304 |
$4K |
| 99204 |
|
33 |
28 |
$2K |
| 92250 |
|
42 |
38 |
$913.07 |
| 92134 |
|
74 |
70 |
$741.87 |
| 92012 |
|
15 |
14 |
$667.06 |
| 99212 |
|
16 |
15 |
$496.47 |
| V2200 |
Lens spher bifoc plano 4.00d |
189 |
184 |
$383.68 |
| 66984 |
|
14 |
12 |
$351.11 |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
33 |
33 |
$11.90 |
| V2781 |
Progressive lens per lens |
109 |
101 |
$0.00 |
| V2744 |
Tint photochromatic lens/es |
98 |
98 |
$0.00 |
| V2750 |
Anti-reflective coating |
102 |
100 |
$0.00 |
| V2025 |
Eyeglasses delux frames |
20 |
20 |
$0.00 |
| 2024F |
|
106 |
106 |
$0.00 |
| V2745 |
Tint, any color/solid/grad |
12 |
12 |
$0.00 |
| 99199 |
|
13 |
13 |
$0.00 |