| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,295 |
3,282 |
$225K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
2,343 |
2,337 |
$155K |
| 92015 |
Determination of refractive state |
87 |
87 |
$756.26 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
14 |
$629.35 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
14 |
$438.75 |