| Code | Description | Claims | Beneficiaries | Total Paid |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,041 |
1,005 |
$97K |
| V2020 |
Frames, purchases |
2,136 |
2,029 |
$85K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,247 |
1,214 |
$57K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,430 |
1,353 |
$28K |
| 92015 |
Determination of refractive state |
1,552 |
1,456 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
102 |
101 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
507 |
465 |
$9K |
| V2025 |
Deluxe frame |
258 |
256 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
213 |
191 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,997 |
1,907 |
$6K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
45 |
44 |
$2K |
| 92025 |
|
59 |
58 |
$2K |
| 92002 |
|
31 |
29 |
$1K |
| 92060 |
|
17 |
13 |
$610.12 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
14 |
12 |
$216.82 |
| 99072 |
|
29 |
28 |
$10.00 |