| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92285 |
|
5,655 |
3,359 |
$139K |
| 92004 |
|
3,929 |
2,942 |
$135K |
| V2020 |
Vision svcs frames purchases |
4,330 |
3,522 |
$62K |
| 92025 |
|
3,469 |
2,824 |
$47K |
| 92250 |
|
2,208 |
1,786 |
$45K |
| 92340 |
|
2,329 |
1,865 |
$14K |
| 92134 |
|
695 |
571 |
$14K |
| 92132 |
|
1,806 |
1,417 |
$11K |
| 92014 |
|
356 |
301 |
$9K |
| 92015 |
|
4,326 |
3,531 |
$5K |
| V2100 |
Lens spher single plano 4.00 |
1,369 |
1,292 |
$5K |
| 92083 |
|
85 |
82 |
$4K |
| V2200 |
Lens spher bifoc plano 4.00d |
377 |
346 |
$3K |
| 92341 |
|
531 |
421 |
$3K |
| V2106 |
Spherocylinder 4.00d/>6.00d |
449 |
396 |
$2K |
| V2101 |
Single visn sphere 4.12-7.00 |
280 |
269 |
$2K |
| 76514 |
|
523 |
407 |
$2K |
| V2784 |
Lens polycarb or equal |
199 |
182 |
$1K |
| 92342 |
|
97 |
80 |
$967.00 |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
63 |
39 |
$589.76 |
| V2206 |
Lens sphcy bifocal 4.00d/ove |
47 |
37 |
$331.40 |
| 92081 |
|
12 |
12 |
$189.00 |
| 92082 |
|
22 |
12 |
$183.34 |
| 92133 |
|
15 |
13 |
$176.02 |
| V2750 |
Anti-reflective coating |
453 |
231 |
$70.00 |
| V2760 |
Scratch resistant coating |
812 |
413 |
$35.00 |
| V2781 |
Progressive lens per lens |
57 |
43 |
$0.00 |