| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
271 |
267 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
176 |
173 |
$13K |
| V2020 |
Frames, purchases |
314 |
288 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
287 |
154 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
305 |
277 |
$7K |
| 92250 |
|
69 |
69 |
$4K |
| 92015 |
Determination of refractive state |
364 |
359 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
187 |
166 |
$2K |
| 92133 |
|
14 |
13 |
$466.46 |