| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,348 |
2,303 |
$110K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,823 |
1,233 |
$38K |
| V2219 |
Bifocal seg width over 28 mm |
304 |
298 |
$22K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
229 |
130 |
$7K |
| 92341 |
|
325 |
320 |
$5K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
69 |
69 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
24 |
$540.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
178 |
87 |
$40.00 |
| V2299 |
Specialty bifocal (by report) |
346 |
172 |
$0.00 |
| V2781 |
Progressive lens, per lens |
346 |
172 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
342 |
170 |
$0.00 |
| V2025 |
Deluxe frame |
62 |
62 |
$0.00 |