| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,196 |
1,159 |
$48K |
| 92341 |
|
407 |
385 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,038 |
992 |
$5K |
| V2755 |
U-v lens, per lens |
815 |
763 |
$5K |
| V2025 |
Deluxe frame |
412 |
384 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
325 |
303 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
802 |
763 |
$3K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
377 |
350 |
$915.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
603 |
577 |
$323.72 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
43 |
37 |
$0.00 |