| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92341 |
|
37 |
33 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
28 |
$0.00 |
| V2020 |
Frames, purchases |
224 |
190 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
148 |
123 |
$0.00 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
78 |
58 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
77 |
64 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
15 |
15 |
$0.00 |