| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,095 |
3,931 |
$175K |
| V2025 |
Deluxe frame |
2,229 |
2,223 |
$101K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,117 |
2,078 |
$96K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,451 |
5,378 |
$82K |
| V2020 |
Frames, purchases |
4,270 |
4,160 |
$73K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,156 |
2,122 |
$46K |
| 92015 |
Determination of refractive state |
730 |
710 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,774 |
2,733 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,845 |
2,807 |
$3K |
| 92250 |
|
46 |
41 |
$930.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
407 |
402 |
$800.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$32.00 |