| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
242 |
164 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
185 |
111 |
$6K |
| V2020 |
Frames, purchases |
359 |
241 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
336 |
223 |
$2K |
| 92015 |
Determination of refractive state |
428 |
278 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
265 |
178 |
$828.70 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
46 |
29 |
$120.00 |