| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,920 |
3,517 |
$107K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,030 |
1,841 |
$65K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,107 |
2,791 |
$60K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
2,200 |
1,959 |
$60K |
| V2219 |
Bifocal seg width over 28 mm |
248 |
228 |
$17K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
371 |
343 |
$17K |
| 92341 |
|
511 |
471 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
178 |
166 |
$5K |
| V2730 |
Special base curve, glass or plastic, per lens |
12 |
12 |
$178.42 |