| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
8,071 |
6,526 |
$1.08M |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,791 |
3,367 |
$317K |
| V2781 |
Progressive lens, per lens |
1,223 |
1,114 |
$197K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,784 |
2,180 |
$169K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,805 |
2,477 |
$121K |
| V2799 |
Vision item or service, miscellaneous |
947 |
933 |
$93K |
| 92341 |
|
951 |
945 |
$33K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
418 |
414 |
$10K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
220 |
220 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
41 |
28 |
$2K |
| 92370 |
|
111 |
111 |
$1K |