| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
720 |
617 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
43 |
40 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
58 |
37 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
27 |
25 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
82 |
73 |
$3K |
| 92002 |
|
14 |
12 |
$909.49 |