| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92250 |
|
220 |
217 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
53 |
53 |
$1K |
| V2020 |
Frames, purchases |
60 |
59 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
55 |
55 |
$667.50 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
40 |
40 |
$620.32 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
24 |
24 |
$505.13 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$78.00 |