| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
10,383 |
10,301 |
$474K |
| 92004 |
|
2,488 |
2,488 |
$292K |
| 92014 |
|
2,732 |
2,731 |
$267K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,093 |
5,061 |
$262K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
946 |
940 |
$74K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,036 |
1,030 |
$50K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,155 |
1,151 |
$48K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,959 |
1,951 |
$44K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
574 |
573 |
$28K |
| 92015 |
|
1,133 |
1,133 |
$17K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
49 |
48 |
$3K |
| 92340 |
|
13 |
13 |
$343.00 |