| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
|
2,205 |
1,945 |
$133K |
| 92014 |
|
1,545 |
1,412 |
$132K |
| 92250 |
|
2,065 |
1,880 |
$95K |
| 92083 |
|
576 |
530 |
$22K |
| 92133 |
|
442 |
410 |
$13K |
| V2020 |
Frames, purchases |
291 |
241 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
329 |
269 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
140 |
110 |
$7K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
79 |
59 |
$7K |
| 92020 |
|
360 |
332 |
$7K |
| 92340 |
|
308 |
253 |
$6K |
| V2750 |
Anti-reflective coating, per lens |
84 |
71 |
$3K |
| 92004 |
|
20 |
17 |
$2K |
| 92225 |
|
13 |
13 |
$504.24 |
| 76514 |
|
72 |
62 |
$490.66 |
| 92285 |
|
17 |
12 |
$165.56 |
| 92015 |
|
35 |
32 |
$76.47 |