| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,338 |
1,165 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
152 |
133 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
49 |
40 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
12 |
$1K |
| V2020 |
Frames, purchases |
68 |
66 |
$359.10 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
15 |
12 |
$191.91 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$98.40 |