| Code | Description | Claims | Beneficiaries | Total Paid |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
966,044 |
949,139 |
$12.67M |
| V2784 |
Lens polycarb or equal |
863,464 |
858,706 |
$6.42M |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
207,166 |
206,162 |
$4.51M |
| V2100 |
Lens spher single plano 4.00 |
375,193 |
370,135 |
$4.37M |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
214,464 |
212,187 |
$2.39M |
| V2107 |
Spherocylinder 4.25d/12-2d |
101,200 |
100,446 |
$1.34M |
| V2200 |
Lens spher bifoc plano 4.00d |
57,052 |
56,704 |
$1.05M |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
51,582 |
51,199 |
$553K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
31,036 |
30,816 |
$367K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
18,675 |
18,599 |
$315K |
| V2101 |
Single visn sphere 4.12-7.00 |
23,953 |
23,779 |
$286K |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
13,462 |
13,366 |
$233K |
| V2207 |
Lens sphcy bifocal 4.25-7d/. |
9,482 |
9,405 |
$202K |
| V2109 |
Spherocylinder 4.25d/4.25-6d |
9,563 |
9,519 |
$111K |
| V2715 |
Prism lens/es |
14,273 |
14,067 |
$107K |
| V2112 |
Spherocylindr 7.25d/2.25-4d |
6,438 |
6,396 |
$103K |
| V2744 |
Tint photochromatic lens/es |
1,483 |
1,479 |
$46K |
| V2102 |
Singl visn sphere 7.12-20.00 |
2,660 |
2,633 |
$44K |
| V2208 |
Lens sphcy bifocal 4.25-7/2. |
1,929 |
1,912 |
$36K |
| V2211 |
Lens sphcy bifo 7.25-12/.25- |
1,279 |
1,270 |
$35K |
| V2201 |
Lens sphere bifocal 4.12-7.0 |
1,631 |
1,617 |
$31K |
| V2205 |
Lens sphcy bifocal 4.00d/4.2 |
1,790 |
1,784 |
$29K |
| V2303 |
Lens sphcy trifocal 4.0/.12- |
697 |
692 |
$23K |
| V2113 |
Spherocylindr 7.25d/4.25-6d |
1,335 |
1,325 |
$20K |
| V2106 |
Spherocylinder 4.00d/>6.00d |
581 |
575 |
$6K |
| V2220 |
Lens bifocal add over 3.25d |
235 |
235 |
$5K |
| V2209 |
Lens sphcy bifocal 4.25-7/4. |
82 |
82 |
$1K |
| V2212 |
Lens sphcyl bifo 7.25-12/2.2 |
56 |
56 |
$1K |
| V2121 |
Lenticular lens, single |
18 |
17 |
$952.92 |
| V2202 |
Lens sphere bifocal 7.12-20. |
15 |
15 |
$369.36 |
| V2755 |
Uv lens/es |
53 |
53 |
$337.61 |
| V2745 |
Tint, any color/solid/grad |
29 |
29 |
$184.73 |
| V2110 |
Spherocylinder 4.25d/over 6d |
14 |
14 |
$154.40 |