| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Lens variab asphericity sing |
26,907 |
19,226 |
$4.35M |
| V2025 |
Eyeglasses delux frames |
23,871 |
16,695 |
$2.45M |
| V2784 |
Lens polycarb or equal |
27,009 |
19,284 |
$929K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
13,425 |
9,873 |
$719K |
| V2750 |
Anti-reflective coating |
26,999 |
19,269 |
$708K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
8,311 |
5,755 |
$557K |
| 92340 |
|
26,948 |
19,227 |
$516K |
| V2730 |
Special base curve |
13,245 |
7,512 |
$472K |
| V2100 |
Lens spher single plano 4.00 |
4,120 |
3,514 |
$188K |
| V2745 |
Tint, any color/solid/grad |
13,733 |
10,723 |
$180K |
| V2020 |
Vision svcs frames purchases |
3,151 |
2,705 |
$108K |
| V2780 |
Oversize lens/es |
402 |
221 |
$9K |
| V2430 |
Lens variable asphericity bi |
60 |
60 |
$9K |
| V2781 |
Progressive lens per lens |
15 |
15 |
$2K |
| V2219 |
Lens bifocal seg width over |
15 |
15 |
$1K |
| 92341 |
|
58 |
58 |
$1K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
15 |
15 |
$0.00 |