| Code | Description | Claims | Beneficiaries | Total Paid |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
11,230 |
10,187 |
$492K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12,981 |
11,983 |
$367K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,159 |
5,621 |
$263K |
| V2025 |
Deluxe frame |
7,470 |
6,929 |
$246K |
| 92015 |
Determination of refractive state |
17,317 |
15,873 |
$245K |
| V2020 |
Frames, purchases |
6,090 |
5,746 |
$116K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,065 |
3,729 |
$74K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,889 |
4,483 |
$62K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
638 |
565 |
$29K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
2,180 |
1,989 |
$26K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
546 |
541 |
$24K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,284 |
2,172 |
$23K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
421 |
400 |
$15K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
291 |
290 |
$13K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
325 |
315 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
246 |
227 |
$4K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
289 |
263 |
$4K |
| V2799 |
Vision item or service, miscellaneous |
18 |
18 |
$599.40 |
| 92310 |
|
12 |
12 |
$464.20 |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$128.62 |
| V2750 |
Anti-reflective coating, per lens |
44 |
42 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
47 |
39 |
$0.00 |