| Code | Description | Claims | Beneficiaries | Total Paid |
| V2020 |
Vision svcs frames purchases |
5,390,120 |
5,168,531 |
$43.23M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
3,780,707 |
2,803,401 |
$31.39M |
| V2784 |
Lens polycarb or equal |
4,013,459 |
2,645,677 |
$27.24M |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,054,309 |
818,552 |
$10.74M |
| V2100 |
Lens spher single plano 4.00 |
1,439,847 |
1,122,409 |
$9.12M |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
576,916 |
479,620 |
$4.64M |
| V2107 |
Spherocylinder 4.25d/12-2d |
393,206 |
322,166 |
$3.06M |
| V2200 |
Lens spher bifoc plano 4.00d |
317,389 |
264,041 |
$2.58M |
| V2106 |
Spherocylinder 4.00d/>6.00d |
86,393 |
58,466 |
$1.59M |
| S0580 |
Polycarb lens |
80,238 |
78,371 |
$1.50M |
| V2744 |
Tint photochromatic lens/es |
80,560 |
47,290 |
$1.23M |
| V2025 |
Eyeglasses delux frames |
54,829 |
51,306 |
$1.08M |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
38,614 |
27,430 |
$1.02M |
| V2204 |
Lens sphcy bifocal 4.00d/2.1 |
88,125 |
78,791 |
$882K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
130,413 |
108,684 |
$878K |
| V2799 |
Misc vision item or service |
16,794 |
9,030 |
$840K |
| V2108 |
Spherocylinder 4.25d/2.12-4d |
110,261 |
95,275 |
$796K |
| V2750 |
Anti-reflective coating |
77,495 |
75,197 |
$710K |
| V2101 |
Single visn sphere 4.12-7.00 |
111,019 |
91,970 |
$700K |
| V2207 |
Lens sphcy bifocal 4.25-7d/. |
66,993 |
57,558 |
$680K |
| V2111 |
Spherocylindr 7.25d/.25-2.25 |
82,101 |
66,290 |
$553K |
| V2303 |
Lens sphcy trifocal 4.0/.12- |
27,100 |
24,335 |
$449K |
| V2715 |
Prism lens/es |
70,322 |
54,197 |
$387K |
| V2781 |
Progressive lens per lens |
58,933 |
32,818 |
$367K |
| V2745 |
Tint, any color/solid/grad |
13,418 |
12,683 |
$266K |
| V2112 |
Spherocylindr 7.25d/2.25-4d |
29,583 |
25,715 |
$206K |
| V2782 |
Lens, 1.54-1.65 p/1.60-1.79g |
7,457 |
5,945 |
$169K |
| V2109 |
Spherocylinder 4.25d/4.25-6d |
25,537 |
22,448 |
$168K |
| V2199 |
Lens single vision not oth c |
1,852 |
1,207 |
$162K |
| V2211 |
Lens sphcy bifo 7.25-12/.25- |
14,738 |
12,708 |
$155K |
| V2208 |
Lens sphcy bifocal 4.25-7/2. |
15,512 |
14,013 |
$143K |
| V2102 |
Singl visn sphere 7.12-20.00 |
17,287 |
14,461 |
$115K |
| V2201 |
Lens sphere bifocal 4.12-7.0 |
13,121 |
11,526 |
$113K |
| V2205 |
Lens sphcy bifocal 4.00d/4.2 |
21,500 |
16,897 |
$110K |
| V2219 |
Lens bifocal seg width over |
6,140 |
4,840 |
$108K |
| V2114 |
Spherocylinder over 12.00d |
13,670 |
11,100 |
$101K |
| V2220 |
Lens bifocal add over 3.25d |
5,164 |
4,325 |
$84K |
| S9999 |
Sales tax |
32,819 |
32,513 |
$66K |
| V2300 |
Lens sphere trifocal 4.00d |
5,807 |
5,264 |
$59K |
| V2212 |
Lens sphcyl bifo 7.25-12/2.2 |
5,014 |
4,504 |
$46K |
| V2113 |
Spherocylindr 7.25d/4.25-6d |
6,676 |
5,865 |
$40K |
| V2760 |
Scratch resistant coating |
11,351 |
11,156 |
$38K |
| V2304 |
Lens sphcy trifocal 4.0/2.25 |
3,119 |
2,934 |
$37K |
| V2756 |
Eye glass case |
128,989 |
127,050 |
$37K |
| V2410 |
Lens variab asphericity sing |
703 |
597 |
$37K |
| V2780 |
Oversize lens/es |
1,876 |
1,753 |
$34K |
| V2307 |
Lens sphcy trifocal 4.25-7/. |
2,212 |
2,036 |
$29K |
| V2202 |
Lens sphere bifocal 7.12-20. |
3,177 |
2,731 |
$28K |
| V2214 |
Lens sphcyl bifocal over 12. |
2,379 |
2,057 |
$28K |
| V2209 |
Lens sphcy bifocal 4.25-7/4. |
2,814 |
2,584 |
$24K |
| V2210 |
Lens sphcy bifocal 4.25-7/ov |
3,086 |
2,076 |
$19K |
| V2110 |
Spherocylinder 4.25d/over 6d |
2,164 |
1,958 |
$15K |
| V2797 |
Vis item/svc in other code |
2,941 |
2,859 |
$14K |
| V2206 |
Lens sphcy bifocal 4.00d/ove |
692 |
632 |
$7K |
| V2213 |
Lens sphcyl bifo 7.25-12/4.2 |
550 |
501 |
$5K |
| V2755 |
Uv lens/es |
1,753 |
1,551 |
$3K |
| V2702 |
Deluxe lens feature |
622 |
622 |
$3K |
| V2221 |
Lenticular lens, bifocal |
151 |
142 |
$3K |
| S0581 |
Nonstnd lens |
753 |
724 |
$3K |
| V2762 |
Polarization, any lens |
275 |
156 |
$2K |
| V2730 |
Special base curve |
1,889 |
940 |
$1K |
| V2299 |
Lens bifocal speciality |
14 |
12 |
$1K |
| V2700 |
Balance lens |
197 |
187 |
$915.00 |
| V2308 |
Lens sphc trifocal 4.25-7/2. |
58 |
53 |
$525.08 |
| V2311 |
Lens sphc trifo 7.25-12/.25- |
12 |
12 |
$156.25 |