| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
217 |
206 |
$23K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
230 |
210 |
$20K |
| 92015 |
Determination of refractive state |
867 |
792 |
$11K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
95 |
89 |
$5K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
38 |
38 |
$2K |