| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,650 |
1,326 |
$44K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
671 |
665 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
603 |
602 |
$27K |
| V2020 |
Frames, purchases |
1,965 |
1,912 |
$21K |
| 92250 |
|
370 |
369 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
221 |
116 |
$2K |
| 92060 |
|
49 |
49 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
79 |
77 |
$885.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$468.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
439 |
204 |
$364.24 |
| 92015 |
Determination of refractive state |
48 |
47 |
$0.00 |