| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,795 |
1,666 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,241 |
1,157 |
$15K |
| 92341 |
|
547 |
491 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
302 |
280 |
$3K |
| V2755 |
U-v lens, per lens |
197 |
191 |
$2K |
| V2025 |
Deluxe frame |
223 |
214 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
393 |
358 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
471 |
419 |
$616.24 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
197 |
191 |
$528.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
123 |
107 |
$0.00 |