| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,334 |
1,131 |
$69K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
939 |
862 |
$40K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
301 |
284 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
260 |
260 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
364 |
302 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
109 |
98 |
$7K |
| 92015 |
Determination of refractive state |
490 |
438 |
$6K |
| V2020 |
Frames, purchases |
206 |
206 |
$2K |
| V2025 |
Deluxe frame |
88 |
88 |
$986.04 |
| 92136 |
|
15 |
12 |
$469.34 |