| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12,249 |
11,793 |
$249K |
| V2020 |
Frames, purchases |
11,491 |
11,458 |
$159K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
2,424 |
2,423 |
$144K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,258 |
6,098 |
$81K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,393 |
4,219 |
$51K |
| V2521 |
Contact lens, hydrophilic, toric, or prism ballast, per lens |
534 |
534 |
$33K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
1,123 |
1,098 |
$14K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
1,185 |
1,155 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
230 |
230 |
$4K |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
108 |
108 |
$1K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
29 |
28 |
$462.00 |
| V2500 |
Contact lens, pmma, spherical, per lens |
160 |
160 |
$100.00 |
| V2025 |
Deluxe frame |
126 |
126 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
109 |
109 |
$0.00 |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
15 |
15 |
$0.00 |