| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,176 |
2,050 |
$137K |
| V2020 |
Frames, purchases |
2,527 |
2,186 |
$65K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
782 |
737 |
$59K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,544 |
987 |
$39K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,642 |
1,936 |
$33K |
| 92015 |
Determination of refractive state |
3,367 |
3,171 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
809 |
548 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
189 |
185 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
38 |
26 |
$1K |