| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,279 |
1,268 |
$55K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
539 |
533 |
$23K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
331 |
331 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
173 |
173 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
97 |
97 |
$4K |
| 92015 |
Determination of refractive state |
60 |
60 |
$3K |
| 92002 |
|
12 |
12 |
$540.00 |