| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
|
1,420 |
1,353 |
$42K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,153 |
1,078 |
$34K |
| V2020 |
Frames, purchases |
1,671 |
1,561 |
$27K |
| V2760 |
Scratch resistant coating, per lens |
1,137 |
1,065 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
786 |
743 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
109 |
104 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
25 |
$367.80 |
| 92370 |
|
17 |
13 |
$294.02 |