| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,418 |
1,657 |
$163K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
2,300 |
1,526 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,258 |
1,501 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,969 |
1,277 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,236 |
801 |
$3K |
| V2755 |
U-v lens, per lens |
1,487 |
1,004 |
$912.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
58 |
36 |
$55.00 |
| 92015 |
Determination of refractive state |
30 |
30 |
$0.00 |