| Code | Description | Claims | Beneficiaries | Total Paid |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
942 |
938 |
$27K |
| 92015 |
Determination of refractive state |
1,720 |
1,682 |
$21K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
133 |
133 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
52 |
52 |
$4K |
| 92002 |
|
44 |
44 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
18 |
18 |
$2K |