| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
13,702 |
13,572 |
$84K |
| V2100 |
Lens spher single plano 4.00 |
14,531 |
9,056 |
$64K |
| V2784 |
Lens polycarb or equal |
6,961 |
4,225 |
$33K |
| 92340 |
|
1,687 |
1,682 |
$30K |
| V2200 |
Lens spher bifoc plano 4.00d |
4,063 |
2,694 |
$30K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,841 |
965 |
$42.00 |
| V2744 |
Tint photochromatic lens/es |
266 |
132 |
$0.00 |
| V2781 |
Progressive lens per lens |
74 |
37 |
$0.00 |
| V2299 |
Lens bifocal speciality |
74 |
37 |
$0.00 |
| V2755 |
Uv lens/es |
86 |
43 |
$0.00 |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
24 |
12 |
$0.00 |
| V2750 |
Anti-reflective coating |
1,114 |
553 |
$0.00 |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
476 |
236 |
$0.00 |
| V2107 |
Spherocylinder 4.25d/12-2d |
26 |
13 |
$0.00 |
| V2760 |
Scratch resistant coating |
80 |
40 |
$0.00 |