| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylindr 4.00d/12-2.00d |
467,420 |
450,095 |
$6.49M |
| V2784 |
Lens polycarb or equal |
360,420 |
352,804 |
$2.84M |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
104,563 |
104,360 |
$2.35M |
| V2100 |
Lens spher single plano 4.00 |
149,188 |
143,950 |
$1.78M |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
112,287 |
109,607 |
$1.32M |
| V2107 |
Spherocylinder 4.25d/12-2d |
44,926 |
43,735 |
$625K |
| V2200 |
Lens spher bifoc plano 4.00d |
30,594 |
30,546 |
$544K |
| V2744 |
Tint photochromatic lens/es |
9,715 |
9,676 |
$331K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
26,088 |
25,605 |
$297K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
16,048 |
15,728 |
$199K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
10,428 |
10,406 |
$178K |
| V2101 |
Single visn sphere 4.12-7.00 |
8,564 |
8,306 |
$106K |
| V2207 |
Lens sphcy bifocal 4.25-7d/. |
4,533 |
4,523 |
$99K |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
5,503 |
5,349 |
$99K |
| V2109 |
Spherocylinder 4.25d/4.25-6d |
5,080 |
4,978 |
$62K |
| V2112 |
Spherocylindr 7.25d/2.25-4d |
3,072 |
2,986 |
$52K |
| V2715 |
Prism lens/es |
4,422 |
4,317 |
$35K |
| V2208 |
Lens sphcy bifocal 4.25-7/2. |
1,085 |
1,081 |
$21K |
| V2205 |
Lens sphcy bifocal 4.00d/4.2 |
1,197 |
1,191 |
$19K |
| V2211 |
Lens sphcy bifo 7.25-12/.25- |
536 |
534 |
$14K |
| V2102 |
Singl visn sphere 7.12-20.00 |
847 |
839 |
$14K |
| V2201 |
Lens sphere bifocal 4.12-7.0 |
680 |
678 |
$13K |
| V2113 |
Spherocylindr 7.25d/4.25-6d |
724 |
724 |
$12K |
| V2303 |
Lens sphcy trifocal 4.0/.12- |
145 |
144 |
$5K |
| V2209 |
Lens sphcy bifocal 4.25-7/4. |
150 |
150 |
$3K |
| V2106 |
Spherocylinder 4.00d/>6.00d |
250 |
249 |
$3K |
| V2220 |
Lens bifocal add over 3.25d |
89 |
89 |
$2K |
| V2212 |
Lens sphcyl bifo 7.25-12/2.2 |
59 |
58 |
$1K |
| V2755 |
Uv lens/es |
178 |
176 |
$1K |