| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,228 |
2,097 |
$203K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,059 |
1,964 |
$164K |
| 92250 |
|
2,570 |
2,459 |
$135K |
| 92060 |
|
2,628 |
2,187 |
$90K |
| 92083 |
|
1,596 |
1,527 |
$69K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
788 |
770 |
$58K |
| V2025 |
Deluxe frame |
3,072 |
2,584 |
$54K |
| V2020 |
Frames, purchases |
2,082 |
1,847 |
$43K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,904 |
2,375 |
$43K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
650 |
533 |
$35K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,175 |
918 |
$18K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,371 |
758 |
$12K |
| 92015 |
Determination of refractive state |
1,351 |
1,238 |
$9K |
| 67938 |
|
25 |
24 |
$6K |
| 99215 |
Prolong outpt/office vis |
70 |
36 |
$4K |
| V2750 |
Anti-reflective coating, per lens |
273 |
253 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,745 |
2,261 |
$2K |
| 92025 |
|
46 |
45 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
136 |
69 |
$1K |
| 92065 |
|
19 |
12 |
$733.33 |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
71 |
41 |
$616.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$539.16 |
| 99417 |
Prolong home eval add 15m |
70 |
36 |
$0.00 |
| 92283 |
|
16 |
15 |
$0.00 |
| 99358 |
Prolong nursin fac eval 15m |
69 |
37 |
$0.00 |