| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,281 |
1,272 |
$84K |
| 92015 |
Determination of refractive state |
2,521 |
2,489 |
$32K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
544 |
544 |
$27K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
393 |
363 |
$11K |
| 92250 |
|
14 |
14 |
$463.12 |
| S9986 |
Not medically necessary service (patient is aware that service not medically necessary) |
12 |
12 |
$56.00 |