| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
2,286 |
2,241 |
$155K |
| 92015 |
|
3,329 |
3,270 |
$125K |
| V2020 |
Frames, purchases |
3,743 |
3,667 |
$111K |
| 92340 |
|
3,551 |
3,479 |
$77K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
2,255 |
2,199 |
$66K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,009 |
1,974 |
$60K |
| 92014 |
|
964 |
952 |
$50K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,329 |
1,299 |
$35K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
50 |
50 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
62 |
58 |
$2K |
| 92341 |
|
12 |
12 |
$294.12 |