| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Eyeglasses delux frames |
11,112 |
9,657 |
$679K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
7,165 |
5,986 |
$131K |
| V2520 |
Contact lens hydrophilic |
1,280 |
1,151 |
$81K |
| V2020 |
Vision svcs frames purchases |
2,777 |
2,340 |
$66K |
| V2781 |
Progressive lens per lens |
848 |
670 |
$62K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,261 |
1,063 |
$45K |
| V2744 |
Tint photochromatic lens/es |
868 |
709 |
$43K |
| V2521 |
Cntct lens hydrophilic toric |
532 |
494 |
$34K |
| V2100 |
Lens spher single plano 4.00 |
1,889 |
1,611 |
$31K |
| V2750 |
Anti-reflective coating |
2,429 |
2,056 |
$28K |
| V2784 |
Lens polycarb or equal |
2,384 |
1,973 |
$25K |
| V2523 |
Cntct lens hydrophil extend |
314 |
250 |
$20K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
1,032 |
899 |
$15K |
| V2107 |
Spherocylinder 4.25d/12-2d |
843 |
711 |
$14K |
| V2200 |
Lens spher bifoc plano 4.00d |
34 |
27 |
$1K |
| V2755 |
Uv lens/es |
150 |
137 |
$938.00 |
| V2799 |
Misc vision item or service |
202 |
125 |
$0.00 |