| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,277 |
3,768 |
$127K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,978 |
2,571 |
$93K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,393 |
4,893 |
$93K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
270 |
250 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
371 |
363 |
$11K |
| 92341 |
|
454 |
426 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
22 |
21 |
$0.00 |