| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
6,011 |
5,672 |
$172K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,348 |
4,175 |
$130K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,298 |
3,127 |
$71K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,897 |
3,685 |
$29K |
| 92370 |
|
603 |
588 |
$17K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
248 |
244 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
464 |
427 |
$8K |
| V2760 |
Scratch resistant coating, per lens |
3,920 |
3,713 |
$7K |
| V2750 |
Anti-reflective coating, per lens |
293 |
291 |
$6K |
| 92341 |
|
109 |
107 |
$3K |
| V2781 |
Progressive lens, per lens |
66 |
63 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
27 |
25 |
$631.53 |
| 99199 |
Unlisted special service, procedure or report |
18 |
18 |
$0.00 |