| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,397 |
2,799 |
$240K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,540 |
1,223 |
$132K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,230 |
3,121 |
$54K |
| 92370 |
|
4,217 |
4,086 |
$27K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
110 |
98 |
$9K |
| 92341 |
|
76 |
76 |
$2K |
| 92015 |
Determination of refractive state |
75 |
68 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18 |
17 |
$1K |
| 92250 |
|
39 |
35 |
$827.97 |
| 92133 |
|
18 |
18 |
$550.24 |
| 68761 |
|
65 |
12 |
$192.08 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13 |
12 |
$59.71 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$0.00 |