| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,028 |
1,026 |
$44K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,003 |
1,002 |
$43K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
90 |
90 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
98 |
98 |
$10K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
54 |
53 |
$4K |
| 92015 |
Determination of refractive state |
31 |
31 |
$382.92 |