| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
167 |
167 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
136 |
136 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
421 |
421 |
$8K |
| 92015 |
Determination of refractive state |
535 |
535 |
$6K |
| 92250 |
|
67 |
66 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
15 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15 |
15 |
$1K |