| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
16,172 |
15,265 |
$2.29M |
| V2523 |
Contact lens, hydrophilic, extended wear, per lens |
6,671 |
6,340 |
$1.71M |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
16,673 |
15,762 |
$1.22M |
| V2025 |
Deluxe frame |
11,657 |
11,111 |
$1.17M |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
16,760 |
15,830 |
$554K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
16,763 |
15,833 |
$302K |
| V2020 |
Frames, purchases |
4,979 |
4,594 |
$174K |
| V2750 |
Anti-reflective coating, per lens |
2,095 |
1,989 |
$69K |
| V2744 |
Tint, photochromatic, per lens |
283 |
278 |
$8K |
| V2205 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
28 |
27 |
$2K |