| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
132,721 |
125,432 |
$1.72M |
| V2750 |
Anti-reflective coating, per lens |
17,108 |
16,180 |
$1.59M |
| V2020 |
Frames, purchases |
135,744 |
128,487 |
$1.56M |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
72,910 |
69,002 |
$870K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
4,244 |
4,102 |
$271K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
22,985 |
21,772 |
$248K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12,680 |
12,214 |
$233K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
16,687 |
15,808 |
$195K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
9,137 |
8,696 |
$101K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
3,196 |
3,079 |
$54K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
4,005 |
3,830 |
$45K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
3,094 |
2,941 |
$34K |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
1,910 |
1,811 |
$22K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
1,651 |
1,557 |
$18K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
610 |
593 |
$12K |
| V2109 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens |
761 |
715 |
$10K |
| V2112 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens |
768 |
730 |
$10K |
| V2715 |
Prism, per lens |
653 |
617 |
$9K |
| V2207 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens |
276 |
269 |
$6K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
91 |
83 |
$2K |
| V2114 |
Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens |
34 |
31 |
$529.47 |
| V2106 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens |
29 |
28 |
$369.63 |
| V2113 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens |
13 |
13 |
$163.40 |