| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
8,332 |
7,837 |
$173K |
| V2750 |
Anti-reflective coating |
4,750 |
4,490 |
$157K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
5,280 |
4,952 |
$127K |
| V2784 |
Lens polycarb or equal |
7,748 |
7,291 |
$61K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
2,194 |
2,023 |
$53K |
| V2100 |
Lens spher single plano 4.00 |
1,475 |
1,379 |
$38K |
| V2025 |
Eyeglasses delux frames |
763 |
682 |
$19K |
| V2107 |
Spherocylinder 4.25d/12-2d |
733 |
650 |
$19K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
295 |
264 |
$7K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
181 |
166 |
$4K |
| V2799 |
Misc vision item or service |
335 |
334 |
$63.01 |