| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,141 |
2,043 |
$58K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,300 |
3,153 |
$56K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
828 |
800 |
$18K |
| V2020 |
Frames, purchases |
3,573 |
3,397 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,523 |
1,470 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
27 |
26 |
$1K |
| 92341 |
|
13 |
12 |
$50.00 |