| Code | Description | Claims | Beneficiaries | Total Paid |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,152 |
1,145 |
$75K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
659 |
649 |
$49K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,549 |
1,532 |
$43K |
| V2020 |
Frames, purchases |
1,079 |
1,067 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
408 |
404 |
$13K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
164 |
164 |
$12K |
| 92015 |
Determination of refractive state |
2,407 |
2,387 |
$12K |
| V2025 |
Deluxe frame |
156 |
156 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
346 |
339 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
12 |
$110.40 |