| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
12,804 |
12,352 |
$444K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
10,829 |
10,713 |
$207K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,275 |
5,158 |
$106K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,780 |
3,700 |
$105K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,502 |
1,382 |
$100K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,885 |
5,805 |
$85K |
| V2025 |
Deluxe frame |
1,594 |
1,582 |
$49K |
| 92341 |
|
1,038 |
1,006 |
$34K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,623 |
1,609 |
$34K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
509 |
502 |
$11K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
187 |
187 |
$9K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
39 |
39 |
$807.20 |
| V2750 |
Anti-reflective coating, per lens |
29 |
29 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
12 |
12 |
$0.00 |