| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
242 |
239 |
$23K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
220 |
215 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
473 |
469 |
$9K |
| V2020 |
Frames, purchases |
428 |
421 |
$8K |
| 92015 |
Determination of refractive state |
717 |
710 |
$4K |
| V2025 |
Deluxe frame |
25 |
25 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
39 |
38 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
26 |
26 |
$941.66 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$876.00 |