| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
129,281 |
129,077 |
$1.21M |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
146,406 |
74,799 |
$935K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
102,870 |
51,330 |
$661K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
75,387 |
40,856 |
$600K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
16,866 |
10,374 |
$108K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
9,187 |
7,192 |
$73K |
| V2205 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
5,754 |
3,494 |
$46K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
3,753 |
2,258 |
$24K |