| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,289 |
2,243 |
$38K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,699 |
1,664 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
991 |
960 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
248 |
239 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
112 |
111 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
92 |
85 |
$1K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
14 |
12 |
$147.00 |