| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,100 |
2,091 |
$114K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,719 |
1,706 |
$77K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,432 |
1,427 |
$67K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,296 |
1,286 |
$55K |
| 92015 |
Determination of refractive state |
1,916 |
1,895 |
$29K |
| 92310 |
|
12 |
12 |
$430.00 |
| 3072F |
|
45 |
45 |
$0.00 |