| Code | Description | Total Paid |
|---|
| V2020 |
Frames, purchases |
$32K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
$15K |
| 92002 |
|
$10K |
| 92341 |
|
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
$3K |
| V2755 |
U-v lens, per lens |
$2K |
| V2025 |
Deluxe frame |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
$616.24 |