| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
149 |
141 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
117 |
103 |
$5K |
| 92015 |
Determination of refractive state |
1,528 |
1,435 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
30 |
30 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
29 |
29 |
$464.00 |