| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
452 |
369 |
$23K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
415 |
321 |
$20K |
| 92015 |
Determination of refractive state |
1,608 |
1,360 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
503 |
225 |
$8K |
| V2020 |
Frames, purchases |
330 |
231 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
135 |
120 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
29 |
29 |
$632.42 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
53 |
26 |
$531.23 |