| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
7,177 |
6,944 |
$324K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,017 |
3,874 |
$246K |
| V2760 |
Scratch resistant coating, per lens |
5,146 |
4,989 |
$114K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,399 |
2,329 |
$91K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
388 |
365 |
$21K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
500 |
489 |
$19K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
189 |
183 |
$18K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,211 |
1,175 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
285 |
278 |
$10K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
21 |
12 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
15 |
15 |
$750.00 |