| Code | Description | Claims | Beneficiaries | Total Paid |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
639 |
600 |
$43K |
| V2020 |
Frames, purchases |
1,123 |
1,063 |
$37K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,128 |
1,066 |
$23K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
423 |
403 |
$11K |
| 92015 |
Determination of refractive state |
600 |
585 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
271 |
268 |
$10K |
| 92002 |
|
59 |
59 |
$4K |