| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
517 |
497 |
$22K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
361 |
354 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
151 |
145 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
75 |
74 |
$5K |
| 92015 |
Determination of refractive state |
561 |
547 |
$4K |