| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
104 |
104 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
41 |
41 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
67 |
67 |
$2K |
| 92015 |
Determination of refractive state |
131 |
130 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$1K |
| 92250 |
|
119 |
119 |
$0.00 |