| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Lens variab asphericity sing |
16,483 |
14,608 |
$2.44M |
| 92014 |
|
9,054 |
8,446 |
$914K |
| V2025 |
Eyeglasses delux frames |
5,836 |
5,406 |
$651K |
| 99213 |
|
7,589 |
6,840 |
$463K |
| V2020 |
Vision svcs frames purchases |
11,707 |
10,515 |
$446K |
| V2784 |
Lens polycarb or equal |
17,844 |
15,902 |
$443K |
| 92004 |
|
3,557 |
3,290 |
$416K |
| V2750 |
Anti-reflective coating |
15,386 |
13,748 |
$375K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
9,169 |
8,277 |
$366K |
| 92340 |
|
18,374 |
16,299 |
$323K |
| 99204 |
|
2,355 |
2,177 |
$312K |
| 99214 |
|
2,341 |
2,160 |
$214K |
| V2744 |
Tint photochromatic lens/es |
11,261 |
10,231 |
$153K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
3,300 |
2,931 |
$150K |
| 92060 |
|
1,641 |
1,516 |
$86K |
| 92201 |
|
3,059 |
961 |
$69K |
| 99232 |
|
902 |
579 |
$46K |
| V2100 |
Lens spher single plano 4.00 |
1,287 |
1,201 |
$45K |
| 92226 |
|
1,060 |
406 |
$25K |
| V2107 |
Spherocylinder 4.25d/12-2d |
400 |
361 |
$19K |
| 92015 |
|
4,875 |
4,456 |
$15K |
| 99070 |
|
707 |
581 |
$14K |
| 99222 |
|
67 |
66 |
$7K |
| 92285 |
|
345 |
325 |
$5K |
| 99233 |
Prolong inpt eval add15 m |
19 |
13 |
$1K |
| 92225 |
|
47 |
30 |
$1K |
| V2101 |
Single visn sphere 4.12-7.00 |
19 |
19 |
$914.45 |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
15 |
12 |
$810.69 |