| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,244 |
3,199 |
$95K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,605 |
2,567 |
$53K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,621 |
1,595 |
$50K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,588 |
1,567 |
$46K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
269 |
268 |
$7K |
| 92341 |
|
153 |
153 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
24 |
$1K |