| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,864 |
1,778 |
$52K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,557 |
1,475 |
$31K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
931 |
868 |
$26K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
880 |
846 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
272 |
256 |
$7K |
| V2219 |
Bifocal seg width over 28 mm |
66 |
62 |
$4K |
| 92341 |
|
198 |
190 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
100 |
95 |
$4K |
| V2730 |
Special base curve, glass or plastic, per lens |
53 |
52 |
$705.56 |