| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
276 |
276 |
$10K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
263 |
261 |
$9K |
| 92015 |
Determination of refractive state |
133 |
133 |
$866.14 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15 |
15 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
29 |
29 |
$0.00 |