| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,712 |
1,192 |
$85K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
487 |
363 |
$67K |
| V2025 |
Deluxe frame |
1,726 |
1,276 |
$50K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,681 |
1,627 |
$45K |
| V2020 |
Frames, purchases |
614 |
485 |
$10K |
| 92341 |
|
178 |
168 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
664 |
638 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
253 |
236 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$135.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
18 |
18 |
$77.00 |
| S0581 |
Nonstandard lens (list this code in addition to the basic code for the lens) |
31 |
31 |
$0.00 |