| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
597 |
594 |
$6K |
| V2799 |
Vision item or service, miscellaneous |
24 |
24 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$868.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$789.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
14 |
14 |
$260.32 |