| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
305 |
300 |
$26K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
324 |
322 |
$21K |
| 92015 |
Determination of refractive state |
418 |
409 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
51 |
45 |
$2K |
| V2020 |
Frames, purchases |
28 |
28 |
$476.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$300.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
17 |
17 |
$200.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
19 |
16 |
$0.00 |
| G8731 |
Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
18 |
15 |
$0.00 |