| Code | Description | Claims | Beneficiaries | Total Paid |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,905 |
1,903 |
$55K |
| V2020 |
Frames, purchases |
2,802 |
2,799 |
$41K |
| V5298 |
Hearing aid, not otherwise classified |
30 |
29 |
$41K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,164 |
1,162 |
$30K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,852 |
1,850 |
$28K |
| 92015 |
Determination of refractive state |
3,329 |
3,325 |
$19K |
| 92341 |
|
779 |
777 |
$18K |