| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
851 |
743 |
$39K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
205 |
173 |
$9K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
138 |
131 |
$6K |
| 92310 |
|
25 |
25 |
$1K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
15 |
15 |
$675.00 |
| 92015 |
Determination of refractive state |
14 |
14 |
$233.35 |