| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,434 |
1,313 |
$95K |
| 92015 |
Determination of refractive state |
2,613 |
2,322 |
$87K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
874 |
803 |
$74K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,678 |
1,534 |
$37K |
| V2020 |
Frames, purchases |
574 |
542 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
224 |
217 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
84 |
70 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15 |
14 |
$827.39 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
19 |
13 |
$676.91 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
18 |
14 |
$659.07 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
30 |
30 |
$499.06 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
15 |
15 |
$232.80 |
| 82962 |
|
131 |
98 |
$116.63 |
| 36416 |
|
132 |
98 |
$115.35 |
| 99072 |
|
81 |
74 |
$0.00 |
| 3008F |
|
15 |
12 |
$0.00 |