| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens polycarb or equal |
132,721 |
125,432 |
$1.72M |
| V2750 |
Anti-reflective coating |
17,108 |
16,180 |
$1.59M |
| V2020 |
Vision svcs frames purchases |
135,744 |
128,487 |
$1.56M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
72,910 |
69,002 |
$870K |
| V2745 |
Tint, any color/solid/grad |
4,244 |
4,102 |
$271K |
| V2100 |
Lens spher single plano 4.00 |
22,985 |
21,772 |
$248K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
12,680 |
12,214 |
$233K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
16,687 |
15,808 |
$195K |
| V2107 |
Spherocylinder 4.25d/12-2d |
9,137 |
8,696 |
$101K |
| V2200 |
Lens spher bifoc plano 4.00d |
3,196 |
3,079 |
$54K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
4,005 |
3,830 |
$45K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
3,094 |
2,941 |
$34K |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
1,910 |
1,811 |
$22K |
| V2101 |
Single visn sphere 4.12-7.00 |
1,651 |
1,557 |
$18K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
610 |
593 |
$12K |
| V2109 |
Spherocylinder 4.25d/4.25-6d |
761 |
715 |
$10K |
| V2112 |
Spherocylindr 7.25d/2.25-4d |
768 |
730 |
$10K |
| V2715 |
Prism lens/es |
653 |
617 |
$9K |
| V2207 |
Lens sphcy bifocal 4.25-7d/. |
276 |
269 |
$6K |
| V2410 |
Lens variab asphericity sing |
91 |
83 |
$2K |
| V2114 |
Spherocylinder over 12.00d |
34 |
31 |
$529.47 |
| V2106 |
Spherocylinder 4.00d/>6.00d |
29 |
28 |
$369.63 |
| V2113 |
Spherocylindr 7.25d/4.25-6d |
13 |
13 |
$163.40 |