| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
122,699 |
114,478 |
$1.56M |
| V2020 |
Frames, purchases |
125,374 |
116,742 |
$1.38M |
| V2750 |
Anti-reflective coating, per lens |
14,729 |
13,633 |
$1.33M |
| V2499 |
Variable sphericity lens, other type |
17,382 |
15,053 |
$1.12M |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
67,628 |
64,007 |
$794K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
20,938 |
19,912 |
$205K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,882 |
1,731 |
$170K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,692 |
5,369 |
$146K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
8,710 |
8,268 |
$108K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
794 |
748 |
$59K |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
4,978 |
4,713 |
$55K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
2,701 |
2,545 |
$30K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,144 |
1,071 |
$30K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
1,546 |
1,458 |
$18K |
| V2114 |
Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens |
1,512 |
1,431 |
$17K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
582 |
561 |
$16K |
| V2112 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens |
1,490 |
1,412 |
$15K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
1,855 |
1,766 |
$14K |
| V2755 |
U-v lens, per lens |
51 |
48 |
$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 |
419 |
390 |
$5K |
| V2201 |
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens |
75 |
74 |
$2K |
| V2113 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens |
117 |
113 |
$1K |
| V2715 |
Prism, per lens |
12 |
12 |
$107.50 |
| V2110 |
Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens |
14 |
14 |
$0.24 |