| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
675 |
666 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
80 |
79 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
27 |
24 |
$2K |
| 92015 |
Determination of refractive state |
998 |
998 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
747 |
747 |
$0.00 |