| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Deluxe frame |
2,747 |
2,703 |
$97K |
| V2020 |
Frames, purchases |
1,661 |
1,621 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,075 |
2,026 |
$35K |
| V2760 |
Scratch resistant coating, per lens |
3,722 |
3,624 |
$14K |
| V2755 |
U-v lens, per lens |
3,693 |
3,599 |
$14K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
519 |
506 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
384 |
371 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
101 |
100 |
$1K |