| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92015 |
Determination of refractive state |
777 |
645 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
265 |
227 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
293 |
235 |
$11K |
| V2020 |
Frames, purchases |
439 |
366 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
369 |
279 |
$9K |
| 92370 |
|
263 |
222 |
$4K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
130 |
108 |
$3K |