| Code | Description | Claims | Beneficiaries | Total Paid |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,050 |
5,752 |
$745K |
| V2020 |
Frames, purchases |
9,620 |
8,842 |
$450K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,000 |
3,812 |
$398K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,183 |
4,781 |
$268K |
| 92015 |
Determination of refractive state |
11,205 |
10,633 |
$177K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,096 |
973 |
$81K |
| V2755 |
U-v lens, per lens |
1,927 |
1,733 |
$51K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
304 |
273 |
$49K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,012 |
918 |
$39K |
| 92002 |
|
503 |
460 |
$21K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
208 |
186 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
259 |
220 |
$12K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
97 |
90 |
$5K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
30 |
25 |
$1K |
| 92310 |
|
48 |
43 |
$240.00 |