| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,714 |
5,813 |
$174K |
| 92341 |
|
1,919 |
1,792 |
$52K |
| V2025 |
Deluxe frame |
3,733 |
3,035 |
$11K |
| V2020 |
Frames, purchases |
4,120 |
3,240 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,001 |
1,544 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,562 |
3,730 |
$745.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
659 |
556 |
$0.00 |
| V2781 |
Progressive lens, per lens |
56 |
36 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
14 |
14 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
492 |
401 |
$0.00 |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
34 |
16 |
$0.00 |