| Code | Description | Claims | Beneficiaries | Total Paid |
| V2020 |
Frames, purchases |
47,642 |
47,498 |
$247K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
45,004 |
26,338 |
$179K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
81,701 |
40,720 |
$163K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15,620 |
9,038 |
$93K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
16,088 |
10,721 |
$64K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
5,670 |
3,946 |
$28K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
4,234 |
3,046 |
$25K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
4,680 |
3,098 |
$23K |
| V2744 |
Tint, photochromatic, per lens |
1,828 |
913 |
$14K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,015 |
773 |
$7K |
| V2207 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens |
982 |
668 |
$7K |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
687 |
475 |
$5K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,014 |
748 |
$5K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
972 |
723 |
$5K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
870 |
630 |
$4K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
211 |
118 |
$2K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
230 |
113 |
$2K |
| V2715 |
Prism, per lens |
1,316 |
702 |
$1K |
| V2112 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens |
110 |
82 |
$654.00 |
| V2211 |
Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
45 |
27 |
$405.00 |
| V2109 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens |
52 |
41 |
$260.00 |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
17 |
13 |
$102.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
190 |
190 |
$100.00 |
| V2750 |
Anti-reflective coating, per lens |
480 |
478 |
$0.00 |
| V2781 |
Progressive lens, per lens |
1,273 |
634 |
$0.00 |
| V2780 |
Oversize lens, per lens |
13 |
13 |
$0.00 |