| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
30,594 |
28,704 |
$875K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
40,118 |
38,092 |
$826K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
19,169 |
10,974 |
$267K |
| 92341 |
|
10,652 |
9,680 |
$203K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,929 |
3,197 |
$114K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,809 |
4,283 |
$106K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,992 |
1,306 |
$28K |
| V2114 |
Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens |
552 |
308 |
$20K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
983 |
686 |
$18K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
1,056 |
693 |
$17K |
| V2700 |
Balance lens, per lens |
177 |
143 |
$3K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
18 |
13 |
$367.74 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
17 |
12 |
$338.30 |
| 92342 |
|
12 |
12 |
$304.52 |
| V2750 |
Anti-reflective coating, per lens |
68 |
68 |
$91.50 |