| Code | Description | Claims | Beneficiaries | Total Paid |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
78 |
75 |
$4K |
| V2020 |
Frames, purchases |
96 |
82 |
$2K |
| 92002 |
|
32 |
32 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
45 |
26 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
53 |
50 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
39 |
38 |
$1K |
| 92015 |
Determination of refractive state |
60 |
37 |
$0.00 |