| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
783 |
781 |
$32K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
969 |
946 |
$20K |
| V2020 |
Frames, purchases |
1,370 |
1,339 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
196 |
195 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
706 |
681 |
$7K |
| 92015 |
Determination of refractive state |
150 |
150 |
$604.07 |