| Code | Description | Claims | Beneficiaries | Total Paid |
| V2020 |
Frames, purchases |
158,079 |
150,717 |
$1.22M |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
87,465 |
83,463 |
$606K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
45,812 |
43,790 |
$292K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
105,097 |
100,675 |
$203K |
| V2760 |
Scratch resistant coating, per lens |
104,814 |
100,460 |
$200K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
18,522 |
17,520 |
$144K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13,238 |
12,630 |
$77K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
10,937 |
10,436 |
$66K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
7,632 |
7,233 |
$50K |
| V2025 |
Deluxe frame |
1,048 |
972 |
$23K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
3,385 |
3,223 |
$18K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
3,245 |
3,089 |
$18K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
2,320 |
2,217 |
$13K |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
1,760 |
1,651 |
$11K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,504 |
1,421 |
$9K |
| V2207 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens |
1,224 |
1,161 |
$8K |
| V2799 |
Vision item or service, miscellaneous |
2,741 |
2,665 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
361 |
264 |
$5K |
| V2112 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens |
785 |
736 |
$4K |
| V2109 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens |
749 |
714 |
$4K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
155 |
152 |
$929.53 |
| V2208 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
64 |
54 |
$330.22 |
| V2211 |
Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
50 |
43 |
$274.00 |
| V2201 |
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens |
31 |
28 |
$189.00 |
| 99199 |
Unlisted special service, procedure or report |
15 |
14 |
$0.00 |