| Code | Description | Claims | Beneficiaries | Total Paid |
| V2020 |
Frames, purchases |
40,751 |
29,835 |
$1.58M |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
30,003 |
21,992 |
$961K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
40,909 |
29,723 |
$934K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
19,486 |
12,805 |
$675K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13,679 |
7,938 |
$545K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,078 |
2,763 |
$282K |
| V2025 |
Deluxe frame |
3,056 |
2,421 |
$276K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,372 |
2,172 |
$263K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,147 |
3,620 |
$186K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
4,555 |
2,664 |
$178K |
| V2755 |
U-v lens, per lens |
5,811 |
4,171 |
$153K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
3,302 |
1,865 |
$143K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
2,510 |
1,426 |
$103K |
| V2109 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens |
496 |
255 |
$21K |
| V2219 |
Bifocal seg width over 28 mm |
134 |
107 |
$13K |
| 92015 |
Determination of refractive state |
5,648 |
5,072 |
$8K |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
197 |
102 |
$8K |
| V2112 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens |
140 |
66 |
$7K |
| 92341 |
|
235 |
174 |
$5K |
| V2114 |
Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens |
27 |
12 |
$2K |
| V2744 |
Tint, photochromatic, per lens |
810 |
676 |
$99.04 |