| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,286 |
1,271 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,035 |
1,028 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
28 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
65 |
63 |
$0.00 |
| V2781 |
Progressive lens, per lens |
65 |
63 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
25 |
25 |
$0.00 |
| V2020 |
Frames, purchases |
2,489 |
2,465 |
$0.00 |