| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,678 |
1,616 |
$48K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,200 |
1,146 |
$24K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
420 |
397 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
385 |
373 |
$11K |
| V2730 |
Special base curve, glass or plastic, per lens |
364 |
346 |
$5K |
| 92341 |
|
26 |
25 |
$580.80 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$318.20 |