| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,751 |
1,750 |
$77K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,412 |
1,398 |
$59K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
948 |
936 |
$55K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
790 |
777 |
$37K |
| 92015 |
Determination of refractive state |
1,009 |
953 |
$14K |