| Code | Description | Claims | Beneficiaries | Total Paid |
| V2020 |
Frames, purchases |
1,721,869 |
1,430,058 |
$15.90M |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,155,628 |
964,810 |
$9.39M |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
242,277 |
197,639 |
$2.61M |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
221,195 |
182,218 |
$1.75M |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
189,931 |
157,731 |
$1.64M |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
138,214 |
115,330 |
$1.04M |
| V2710 |
Slab off prism, glass or plastic, per lens |
16,196 |
12,730 |
$606K |
| V2780 |
Oversize lens, per lens |
238,376 |
191,196 |
$596K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
52,293 |
42,935 |
$480K |
| V2730 |
Special base curve, glass or plastic, per lens |
26,569 |
22,734 |
$405K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
18,489 |
15,228 |
$398K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
39,220 |
32,274 |
$308K |
| S0581 |
Nonstandard lens (list this code in addition to the basic code for the lens) |
19,669 |
16,161 |
$282K |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
22,339 |
18,491 |
$223K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
21,369 |
17,315 |
$190K |
| V2207 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens |
13,528 |
10,996 |
$122K |
| V2112 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens |
9,586 |
7,917 |
$99K |
| V2109 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens |
10,221 |
8,433 |
$93K |
| V2114 |
Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens |
3,393 |
2,844 |
$67K |
| V2106 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens |
3,584 |
2,913 |
$42K |
| V2115 |
Lenticular, (myodisc), per lens, single vision |
4,036 |
3,648 |
$42K |
| V2715 |
Prism, per lens |
8,502 |
7,165 |
$35K |
| V2211 |
Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
2,900 |
2,387 |
$35K |
| V2217 |
|
1,926 |
1,473 |
$34K |
| V2208 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
2,897 |
2,344 |
$26K |
| V2205 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
2,314 |
1,839 |
$23K |
| V2113 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens |
1,794 |
1,484 |
$20K |
| V2215 |
Lenticular (myodisc), per lens, bifocal |
1,005 |
936 |
$13K |
| V2220 |
Bifocal add over 3.25d |
1,517 |
1,232 |
$10K |
| V2700 |
Balance lens, per lens |
1,941 |
1,203 |
$9K |
| V2212 |
Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens |
476 |
423 |
$6K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
138 |
123 |
$2K |
| V2110 |
Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens |
93 |
67 |
$1K |
| V2214 |
Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens |
43 |
37 |
$816.49 |
| V2209 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens |
40 |
40 |
$481.05 |
| V2219 |
Bifocal seg width over 28 mm |
88 |
88 |
$151.00 |