| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
29,646 |
27,976 |
$844K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
23,634 |
22,179 |
$471K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15,327 |
14,578 |
$453K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
12,551 |
11,933 |
$354K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
7,785 |
7,430 |
$323K |
| 92341 |
|
9,165 |
8,776 |
$210K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,867 |
4,646 |
$113K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,897 |
1,819 |
$60K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
1,641 |
1,527 |
$53K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
2,094 |
2,003 |
$51K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
159 |
153 |
$5K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
27 |
25 |
$912.42 |