| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
277 |
276 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
95 |
94 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
103 |
100 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
218 |
216 |
$3K |
| 92015 |
Determination of refractive state |
164 |
163 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$494.34 |