| Code | Description | Claims | Beneficiaries | Total Paid |
| 92285 |
|
819 |
614 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
525 |
510 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
572 |
471 |
$2K |
| 92015 |
Determination of refractive state |
831 |
805 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
400 |
335 |
$1K |
| V2020 |
Frames, purchases |
283 |
283 |
$1K |
| 92341 |
|
59 |
59 |
$329.13 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
69 |
69 |
$252.07 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15 |
15 |
$177.50 |