| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
617 |
579 |
$69K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
561 |
528 |
$57K |
| V2750 |
Anti-reflective coating, per lens |
890 |
822 |
$23K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
868 |
805 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
474 |
450 |
$9K |
| V2020 |
Frames, purchases |
224 |
208 |
$9K |
| 92015 |
Determination of refractive state |
2,603 |
2,457 |
$3K |
| V2025 |
Deluxe frame |
44 |
42 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
27 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
19 |
13 |
$756.56 |