| Code | Description | Claims | Beneficiaries | Total Paid |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,332 |
2,297 |
$53K |
| V2020 |
Frames, purchases |
3,002 |
2,952 |
$43K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,534 |
2,485 |
$27K |
| 92015 |
Determination of refractive state |
3,587 |
3,518 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
390 |
359 |
$11K |
| 92341 |
|
13 |
13 |
$413.40 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
16 |
15 |
$313.04 |