| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,956 |
1,891 |
$56K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,627 |
1,559 |
$33K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,035 |
1,004 |
$29K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
832 |
798 |
$24K |
| 92341 |
|
228 |
221 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
96 |
93 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
139 |
134 |
$3K |
| V2730 |
Special base curve, glass or plastic, per lens |
68 |
66 |
$940.76 |