| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
368 |
327 |
$13K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
341 |
307 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
61 |
59 |
$436.25 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
21 |
20 |
$258.75 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
34 |
33 |
$133.75 |