| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0620 |
Routine ophthalmological examination including refraction; new patient |
3,469 |
3,368 |
$335K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,040 |
1,006 |
$80K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
90 |
85 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
30 |
30 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
120 |
113 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
36 |
26 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
42 |
40 |
$488.40 |
| 92015 |
Determination of refractive state |
56 |
55 |
$0.00 |