| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
2,592 |
2,536 |
$288K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,592 |
4,410 |
$91K |
| V2020 |
Frames, purchases |
3,787 |
3,682 |
$63K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,816 |
895 |
$54K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
726 |
702 |
$35K |
| 92341 |
|
1,096 |
1,057 |
$27K |
| V2430 |
Variable asphericity lens, bifocal, full field, glass or plastic, per lens |
134 |
67 |
$6K |
| V2110 |
Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens |
31 |
31 |
$603.26 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
44 |
44 |
$542.76 |
| V2109 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens |
19 |
19 |
$369.74 |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
16 |
16 |
$311.36 |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
14 |
14 |
$272.44 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
13 |
$247.24 |