| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,659 |
4,343 |
$188K |
| 92014 |
|
1,935 |
1,802 |
$109K |
| 92012 |
|
1,866 |
1,692 |
$76K |
| 92004 |
|
895 |
842 |
$73K |
| V2760 |
Scratch resistant coating, per lens |
3,147 |
2,976 |
$63K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,100 |
1,031 |
$58K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,053 |
996 |
$56K |
| 92015 |
|
4,461 |
4,150 |
$22K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
246 |
227 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
305 |
293 |
$14K |