| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,336 |
2,282 |
$105K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,042 |
1,003 |
$47K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
260 |
260 |
$11K |
| S0592 |
Comprehensive contact lens evaluation |
265 |
265 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
67 |
67 |
$3K |
| 92015 |
Determination of refractive state |
140 |
140 |
$1K |