| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
2,305 |
1,496 |
$333K |
| V2020 |
Frames, purchases |
5,411 |
3,490 |
$213K |
| 92014 |
|
1,956 |
1,803 |
$197K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,395 |
3,472 |
$196K |
| 92004 |
|
1,225 |
1,124 |
$144K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,497 |
1,781 |
$130K |
| 92340 |
|
5,172 |
3,326 |
$99K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,700 |
762 |
$57K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,767 |
723 |
$52K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
74 |
39 |
$3K |
| 92015 |
|
278 |
253 |
$3K |