| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
87 |
82 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
45 |
45 |
$4K |
| 92015 |
Determination of refractive state |
308 |
292 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
25 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
61 |
54 |
$890.11 |