| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
759 |
692 |
$82K |
| 92250 |
|
1,066 |
969 |
$62K |
| 92081 |
|
1,067 |
973 |
$27K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
378 |
366 |
$17K |
| 92015 |
Determination of refractive state |
389 |
360 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
30 |
27 |
$3K |
| 92285 |
|
141 |
135 |
$2K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
32 |
31 |
$2K |