| Code | Description | Claims | Beneficiaries | Total Paid |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
399 |
386 |
$25K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
151 |
146 |
$9K |
| 92015 |
Determination of refractive state |
605 |
587 |
$5K |
| V2020 |
Frames, purchases |
442 |
430 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
424 |
413 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
311 |
301 |
$2K |