| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
115 |
115 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
42 |
42 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
26 |
26 |
$941.20 |
| 92341 |
|
26 |
25 |
$761.28 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
35 |
29 |
$556.70 |
| 92015 |
Determination of refractive state |
78 |
78 |
$497.86 |