| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
9,068 |
8,796 |
$261K |
| 92015 |
|
5,594 |
5,482 |
$208K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
6,513 |
6,366 |
$186K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,683 |
5,561 |
$173K |
| 92014 |
|
3,396 |
3,307 |
$165K |
| 92340 |
|
7,775 |
7,581 |
$159K |
| 92004 |
|
2,185 |
2,137 |
$142K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,155 |
1,123 |
$24K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
470 |
457 |
$23K |
| 92341 |
|
763 |
746 |
$18K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
378 |
368 |
$14K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
258 |
254 |
$7K |