| V2219 | Bifocal seg width over 28 mm | 4 | 10 | 1,740 | $70 | $142.3K |
| 99204 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider… | 63 | 80 | 100 | $120 | $131.8K |
| V2025 | Deluxe frame | 7 | 10 | 1,270 | $60 | $110.9K |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 7 | 20 | 520 | $70 | $84.2K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 20 | 50 | 440 | $80 | $82.7K |
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 8 | 50 | 720 | $60 | $80.7K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 16 | 30 | 910 | $40 | $79.2K |
| V2760 | Scratch resistant coating, per lens | 6 | 10 | 1,170 | $30 | $66.8K |
| V2783 | Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens | 2 | 10 | 380 | $110 | $59.7K |
| 92250 | Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,… | 21 | 20 | 510 | $30 | $50.2K |