| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
341 |
341 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
313 |
286 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
298 |
288 |
$11K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
158 |
158 |
$7K |
| S0592 |
Comprehensive contact lens evaluation |
47 |
47 |
$2K |
| 92015 |
Determination of refractive state |
57 |
52 |
$248.50 |