| Code | Description | Claims | Beneficiaries | Total Paid |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,287 |
1,284 |
$108K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,009 |
1,003 |
$106K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,060 |
2,048 |
$74K |
| 92015 |
Determination of refractive state |
2,666 |
2,653 |
$17K |
| V2020 |
Frames, purchases |
928 |
919 |
$16K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
68 |
68 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
590 |
588 |
$4K |
| 92370 |
|
22 |
22 |
$440.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
19 |
19 |
$158.08 |