| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,025 |
2,024 |
$97K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,912 |
1,909 |
$86K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
538 |
537 |
$25K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
115 |
115 |
$6K |
| 92015 |
Determination of refractive state |
939 |
937 |
$3K |
| 92250 |
|
24 |
24 |
$760.00 |
| 3072F |
|
2,198 |
2,184 |
$0.00 |