| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,610 |
2,588 |
$192K |
| V2020 |
Frames, purchases |
5,644 |
5,605 |
$120K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,408 |
2,389 |
$88K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
901 |
898 |
$28K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,312 |
2,307 |
$25K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
630 |
627 |
$14K |
| 92341 |
|
672 |
669 |
$11K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
145 |
145 |
$9K |