| Code | Description | Claims | Beneficiaries | Total Paid |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,777 |
1,774 |
$63K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,394 |
1,390 |
$49K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,423 |
1,422 |
$28K |
| V2020 |
Frames, purchases |
1,410 |
1,409 |
$27K |
| 92015 |
Determination of refractive state |
3,166 |
3,163 |
$23K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
442 |
391 |
$9K |