| Code | Description | Claims | Beneficiaries | Total Paid |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,094 |
1,071 |
$53K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
349 |
345 |
$20K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
250 |
243 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
141 |
137 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
65 |
64 |
$4K |