| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,771 |
1,770 |
$81K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,266 |
1,247 |
$54K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
923 |
923 |
$48K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
275 |
272 |
$12K |
| 92015 |
Determination of refractive state |
274 |
267 |
$4K |
| 3072F |
|
1,347 |
1,347 |
$240.00 |