| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
5,200 |
5,155 |
$227K |
| 92310 |
|
924 |
899 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
642 |
622 |
$25K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
334 |
334 |
$14K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
152 |
151 |
$5K |
| V2799 |
Vision item or service, miscellaneous |
14 |
13 |
$280.00 |
| 92250 |
|
92 |
91 |
$58.49 |
| 92015 |
Determination of refractive state |
36 |
32 |
$0.00 |