| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
25,339 |
24,286 |
$705K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
20,227 |
19,403 |
$398K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13,769 |
13,204 |
$397K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
11,028 |
10,577 |
$307K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,458 |
4,304 |
$188K |
| 92341 |
|
5,359 |
5,200 |
$123K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,165 |
4,045 |
$96K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,392 |
1,358 |
$35K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
556 |
537 |
$18K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
435 |
420 |
$14K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
40 |
37 |
$1K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
14 |
13 |
$660.40 |
| V2744 |
Tint, photochromatic, per lens |
13 |
13 |
$288.19 |
| 92370 |
|
29 |
29 |
$184.80 |