| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
239 |
239 |
$66K |
| 92002 |
|
1,026 |
1,020 |
$25K |
| V2020 |
Frames, purchases |
1,911 |
1,897 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,042 |
1,040 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
439 |
383 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
991 |
962 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
864 |
460 |
$5K |
| 92015 |
Determination of refractive state |
223 |
223 |
$3K |
| 92250 |
|
45 |
45 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
239 |
115 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
134 |
134 |
$2K |
| 92341 |
|
92 |
92 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
55 |
55 |
$1K |