| Code | Description | Claims | Beneficiaries | Total Paid |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,081 |
1,050 |
$52K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
400 |
390 |
$22K |
| 92015 |
Determination of refractive state |
482 |
448 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
251 |
233 |
$11K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
142 |
138 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
25 |
25 |
$2K |