| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
41 |
40 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$696.64 |
| 92015 |
Determination of refractive state |
800 |
727 |
$4.40 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
216 |
213 |
$0.00 |
| V2020 |
Frames, purchases |
14 |
14 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
15 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$0.00 |