| Code | Description | Claims | Bene. Records | Total Paid |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,574 |
1,539 |
$45K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,813 |
1,791 |
$26K |
| 92015 |
Determination of refractive state |
1,770 |
1,722 |
$16K |
| V2020 |
Frames, purchases |
460 |
442 |
$8K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
119 |
119 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
240 |
226 |
$4K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
39 |
39 |
$2K |