| Code | Description | Claims | Beneficiaries | Total Paid |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
8,111 |
7,718 |
$920K |
| V2020 |
Frames, purchases |
16,314 |
15,152 |
$662K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,006 |
6,703 |
$651K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
7,548 |
7,067 |
$373K |
| 92015 |
Determination of refractive state |
16,979 |
16,131 |
$256K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,559 |
2,357 |
$113K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
632 |
567 |
$108K |
| V2755 |
U-v lens, per lens |
2,917 |
2,702 |
$79K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
939 |
838 |
$64K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
831 |
780 |
$37K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
465 |
356 |
$24K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
124 |
118 |
$7K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
39 |
37 |
$3K |
| 92002 |
|
42 |
38 |
$2K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
13 |
13 |
$557.18 |
| 92310 |
|
41 |
37 |
$435.00 |
| V2750 |
Anti-reflective coating, per lens |
19 |
16 |
$0.00 |