| Code | Description | Claims | Beneficiaries | Total Paid |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,346,875 |
1,326,672 |
$17.56M |
| V2784 |
Lens polycarb or equal |
1,226,033 |
1,217,019 |
$9.05M |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
310,973 |
308,935 |
$6.75M |
| V2100 |
Lens spher single plano 4.00 |
522,884 |
516,673 |
$6.04M |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
305,223 |
302,174 |
$3.39M |
| V2107 |
Spherocylinder 4.25d/12-2d |
134,724 |
133,661 |
$1.77M |
| V2200 |
Lens spher bifoc plano 4.00d |
80,739 |
80,188 |
$1.47M |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
67,103 |
66,560 |
$718K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
44,360 |
44,050 |
$521K |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
29,853 |
29,693 |
$500K |
| V2101 |
Single visn sphere 4.12-7.00 |
30,747 |
30,523 |
$362K |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
16,448 |
16,322 |
$280K |
| V2207 |
Lens sphcy bifocal 4.25-7d/. |
12,608 |
12,529 |
$268K |
| V2109 |
Spherocylinder 4.25d/4.25-6d |
13,715 |
13,613 |
$159K |
| V2112 |
Spherocylindr 7.25d/2.25-4d |
8,776 |
8,709 |
$139K |
| V2744 |
Tint photochromatic lens/es |
4,239 |
4,220 |
$134K |
| V2715 |
Prism lens/es |
13,315 |
13,084 |
$98K |
| V2208 |
Lens sphcy bifocal 4.25-7/2. |
3,003 |
2,990 |
$56K |
| V2205 |
Lens sphcy bifocal 4.00d/4.2 |
3,242 |
3,217 |
$52K |
| V2102 |
Singl visn sphere 7.12-20.00 |
3,110 |
3,081 |
$49K |
| V2211 |
Lens sphcy bifo 7.25-12/.25- |
1,820 |
1,805 |
$49K |
| V2201 |
Lens sphere bifocal 4.12-7.0 |
2,156 |
2,143 |
$41K |
| V2113 |
Spherocylindr 7.25d/4.25-6d |
2,265 |
2,252 |
$35K |
| V2303 |
Lens sphcy trifocal 4.0/.12- |
956 |
952 |
$32K |
| V2755 |
Uv lens/es |
2,438 |
2,379 |
$16K |
| V2220 |
Lens bifocal add over 3.25d |
787 |
782 |
$15K |
| V2745 |
Tint, any color/solid/grad |
1,779 |
1,750 |
$11K |
| V2106 |
Spherocylinder 4.00d/>6.00d |
1,137 |
1,125 |
$11K |
| V2209 |
Lens sphcy bifocal 4.25-7/4. |
367 |
364 |
$6K |
| V2212 |
Lens sphcyl bifo 7.25-12/2.2 |
231 |
230 |
$6K |
| V2121 |
Lenticular lens, single |
14 |
14 |
$741.16 |
| V2110 |
Spherocylinder 4.25d/over 6d |
50 |
50 |
$531.84 |