| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
10,229 |
10,071 |
$150K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,726 |
4,645 |
$102K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,080 |
5,012 |
$88K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,209 |
1,193 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
913 |
898 |
$16K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
610 |
595 |
$10K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
227 |
227 |
$9K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
145 |
136 |
$7K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
310 |
306 |
$6K |
| V2521 |
Contact lens, hydrophilic, toric, or prism ballast, per lens |
41 |
40 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
42 |
42 |
$0.00 |