| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Deluxe frame |
604 |
599 |
$30K |
| 92004 |
|
733 |
700 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
685 |
671 |
$22K |
| 92014 |
|
473 |
447 |
$19K |
| V2020 |
Frames, purchases |
74 |
64 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
26 |
$1K |
| 92015 |
|
1,050 |
999 |
$217.39 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
45 |
45 |
$49.22 |
| V2760 |
Scratch resistant coating, per lens |
21 |
21 |
$18.00 |