| Code | Description | Claims | Beneficiaries | Total Paid |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
320 |
278 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
78 |
77 |
$3K |
| 92015 |
Determination of refractive state |
240 |
238 |
$2K |
| V2020 |
Frames, purchases |
224 |
221 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
220 |
216 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$0.00 |