| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,996 |
2,463 |
$0.00 |
| 92004 |
|
1,805 |
1,804 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,568 |
1,277 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
197 |
96 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
691 |
344 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,353 |
2,135 |
$0.00 |
| V2781 |
Progressive lens, per lens |
117 |
59 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
86 |
43 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
86 |
43 |
$0.00 |
| 92014 |
|
5,200 |
5,197 |
$0.00 |
| V2020 |
Frames, purchases |
5,642 |
5,560 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
310 |
155 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
455 |
224 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
30 |
15 |
$0.00 |