| Code | Description | Claims | Beneficiaries | Total Paid |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,255 |
4,988 |
$263K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,630 |
3,557 |
$193K |
| V2020 |
Frames, purchases |
918 |
912 |
$38K |
| 92015 |
Determination of refractive state |
8,168 |
7,871 |
$38K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
753 |
740 |
$35K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
657 |
654 |
$22K |
| 92002 |
|
446 |
444 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
288 |
287 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
332 |
267 |
$13K |
| 92250 |
|
500 |
439 |
$8K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
127 |
127 |
$6K |
| V2025 |
Deluxe frame |
91 |
91 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
910 |
902 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
82 |
61 |
$4K |
| 92083 |
|
121 |
105 |
$3K |
| 83861 |
|
185 |
75 |
$2K |
| 92133 |
|
43 |
39 |
$887.72 |
| 92136 |
|
13 |
13 |
$472.74 |
| V2750 |
Anti-reflective coating, per lens |
57 |
57 |
$238.88 |
| 92020 |
|
16 |
16 |
$216.07 |
| 92285 |
|
14 |
13 |
$201.57 |
| V2755 |
U-v lens, per lens |
63 |
63 |
$54.33 |