| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
26,135 |
25,574 |
$613K |
| V2020 |
Frames, purchases |
25,552 |
24,801 |
$415K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
19,961 |
19,590 |
$371K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12,273 |
12,035 |
$197K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
7,488 |
7,389 |
$121K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
2,710 |
2,665 |
$44K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
1,379 |
1,343 |
$22K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
196 |
186 |
$4K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
140 |
137 |
$2K |
| 92341 |
|
85 |
81 |
$2K |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
43 |
42 |
$860.00 |
| V2025 |
Deluxe frame |
74 |
73 |
$614.00 |