| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,133 |
3,091 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
1,043 |
521 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
757 |
380 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
616 |
307 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,651 |
1,318 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
74 |
37 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,258 |
1,108 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
306 |
153 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
438 |
219 |
$0.00 |
| V2781 |
Progressive lens, per lens |
98 |
50 |
$0.00 |