| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
949 |
948 |
$45K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
787 |
787 |
$34K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
283 |
283 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
76 |
76 |
$4K |
| 92310 |
|
43 |
43 |
$2K |
| 92015 |
Determination of refractive state |
612 |
612 |
$104.15 |