| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,640 |
2,099 |
$141K |
| V2020 |
Frames, purchases |
245 |
244 |
$46K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
551 |
367 |
$22K |
| 92015 |
Determination of refractive state |
3,341 |
1,841 |
$13K |
| 92310 |
|
39 |
39 |
$9K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
141 |
141 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
74 |
74 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
12 |
12 |
$535.00 |