| Code | Description | Claims | Bene. Records | Total Paid |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
622 |
447 |
$18K |
| 92015 |
Determination of refractive state |
429 |
417 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
24 |
24 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15 |
13 |
$819.29 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$696.89 |