| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
347 |
341 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
85 |
84 |
$8K |
| 92015 |
Determination of refractive state |
117 |
117 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
31 |
29 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$1K |