| Code | Description | Claims | Beneficiaries | Total Paid |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
571 |
484 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,150 |
1,022 |
$21K |
| 92370 |
|
1,981 |
1,786 |
$14K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
13 |
12 |
$1K |
| 92015 |
Determination of refractive state |
72 |
65 |
$967.18 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
31 |
24 |
$619.23 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
13 |
$361.26 |
| G8732 |
No documentation of pain assessment, reason not given |
69 |
61 |
$0.00 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
106 |
97 |
$0.00 |