| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
522 |
481 |
$20K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
230 |
227 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
142 |
137 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
232 |
224 |
$8K |
| 92015 |
Determination of refractive state |
532 |
508 |
$553.69 |