| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
90 |
85 |
$15K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
82 |
53 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
16 |
15 |
$1K |
| 92015 |
Determination of refractive state |
41 |
28 |
$830.20 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$240.00 |