| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,394 |
4,267 |
$84K |
| V2020 |
Frames, purchases |
4,889 |
4,734 |
$70K |
| 92014 |
|
3,246 |
3,058 |
$70K |
| 92004 |
|
1,257 |
1,186 |
$25K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,184 |
3,097 |
$24K |
| V2781 |
Progressive lens, per lens |
279 |
259 |
$11K |
| V2299 |
Specialty bifocal (by report) |
292 |
272 |
$8K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
85 |
80 |
$2K |
| 92015 |
|
1,938 |
1,793 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
1,302 |
1,217 |
$0.00 |