| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,411 |
1,403 |
$43K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
874 |
862 |
$23K |
| V2020 |
Frames, purchases |
1,487 |
1,477 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
118 |
117 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
15 |
15 |
$418.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,590 |
1,567 |
$0.00 |