| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens polycarb or equal |
122,699 |
114,478 |
$1.56M |
| V2020 |
Vision svcs frames purchases |
125,374 |
116,742 |
$1.38M |
| V2750 |
Anti-reflective coating |
14,729 |
13,633 |
$1.33M |
| V2499 |
Variable asphericity lens |
17,382 |
15,053 |
$1.12M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
67,628 |
64,007 |
$794K |
| V2100 |
Lens spher single plano 4.00 |
20,938 |
19,912 |
$205K |
| V2410 |
Lens variab asphericity sing |
1,882 |
1,731 |
$170K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
5,692 |
5,369 |
$146K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
8,710 |
8,268 |
$108K |
| V2745 |
Tint, any color/solid/grad |
794 |
748 |
$59K |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
4,978 |
4,713 |
$55K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
2,701 |
2,545 |
$30K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
1,144 |
1,071 |
$30K |
| V2107 |
Spherocylinder 4.25d/12-2d |
1,546 |
1,458 |
$18K |
| V2114 |
Spherocylinder over 12.00d |
1,512 |
1,431 |
$17K |
| V2200 |
Lens spher bifoc plano 4.00d |
582 |
561 |
$16K |
| V2112 |
Spherocylindr 7.25d/2.25-4d |
1,490 |
1,412 |
$15K |
| V2101 |
Single visn sphere 4.12-7.00 |
1,855 |
1,766 |
$14K |
| V2755 |
Uv lens/es |
51 |
48 |
$5K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
419 |
390 |
$5K |
| V2201 |
Lens sphere bifocal 4.12-7.0 |
75 |
74 |
$2K |
| V2113 |
Spherocylindr 7.25d/4.25-6d |
117 |
113 |
$1K |
| V2715 |
Prism lens/es |
12 |
12 |
$107.50 |
| V2110 |
Spherocylinder 4.25d/over 6d |
14 |
14 |
$0.24 |