| Code | Description | Claims | Beneficiaries | Total Paid |
| V2020 |
Frames, purchases |
8,933 |
8,653 |
$255K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,191 |
2,172 |
$76K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,307 |
3,148 |
$75K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,443 |
1,389 |
$31K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
273 |
272 |
$13K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
370 |
350 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,925 |
3,722 |
$7K |
| 92340 |
|
3,428 |
3,397 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
19 |
19 |
$630.20 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
24 |
24 |
$616.62 |
| V2799 |
Vision item or service, miscellaneous |
639 |
637 |
$568.62 |
| V2744 |
Tint, photochromatic, per lens |
916 |
903 |
$100.00 |
| V2750 |
Anti-reflective coating, per lens |
274 |
263 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
173 |
162 |
$0.00 |
| V2781 |
Progressive lens, per lens |
75 |
74 |
$0.00 |