| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
7,099 |
6,867 |
$161K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,099 |
4,923 |
$137K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,961 |
3,877 |
$76K |
| 92341 |
|
1,996 |
1,934 |
$70K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,732 |
1,686 |
$44K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,329 |
5,124 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
860 |
777 |
$10K |
| 00000 |
|
100 |
22 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
110 |
105 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
17 |
17 |
$247.98 |
| V2756 |
Eye glass case |
74 |
69 |
$93.30 |