| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
896 |
892 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
321 |
321 |
$23K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
240 |
240 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
201 |
201 |
$14K |
| V2020 |
Frames, purchases |
498 |
496 |
$12K |
| V2025 |
Deluxe frame |
285 |
285 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
973 |
968 |
$1K |
| 92015 |
Determination of refractive state |
832 |
832 |
$1K |