| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
|
3,480 |
3,362 |
$59K |
| V2020 |
Frames, purchases |
11,136 |
10,458 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,153 |
589 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
8,240 |
3,901 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,950 |
1,496 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
10,866 |
5,047 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
4,362 |
2,097 |
$0.00 |
| V2599 |
Contact lens, other type |
357 |
354 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
26 |
12 |
$0.00 |