| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
7,035 |
6,566 |
$273K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,096 |
1,971 |
$138K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
2,580 |
2,550 |
$107K |
| 92250 |
|
672 |
658 |
$41K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
348 |
340 |
$40K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
295 |
279 |
$26K |
| 92002 |
|
121 |
120 |
$8K |
| 92015 |
Determination of refractive state |
275 |
271 |
$3K |
| 92065 |
|
57 |
55 |
$2K |
| 76514 |
|
14 |
14 |
$178.22 |
| 3072F |
|
29 |
28 |
$0.00 |