| Code | Description | Claims | Beneficiaries | Total Paid |
| V2020 |
Frames, purchases |
31,111 |
30,129 |
$127K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
29,535 |
16,943 |
$109K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14,143 |
8,849 |
$53K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
26,353 |
13,084 |
$49K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
8,254 |
4,766 |
$45K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
3,413 |
2,315 |
$16K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,725 |
1,887 |
$15K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
2,854 |
1,906 |
$13K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
820 |
595 |
$4K |
| V2744 |
Tint, photochromatic, per lens |
1,393 |
696 |
$3K |
| V2207 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens |
485 |
319 |
$3K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
442 |
339 |
$3K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
525 |
390 |
$2K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
456 |
324 |
$2K |
| V2111 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens |
280 |
186 |
$2K |
| V2715 |
Prism, per lens |
472 |
272 |
$406.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
71 |
70 |
$14.00 |
| V2750 |
Anti-reflective coating, per lens |
1,066 |
1,050 |
$8.00 |
| V2781 |
Progressive lens, per lens |
1,222 |
601 |
$0.00 |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
86 |
43 |
$0.00 |