| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,345 |
4,116 |
$270K |
| V2020 |
Frames, purchases |
7,235 |
6,824 |
$166K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,076 |
1,974 |
$151K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,034 |
2,842 |
$97K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,624 |
2,485 |
$92K |
| 92015 |
Determination of refractive state |
6,576 |
6,234 |
$81K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
984 |
901 |
$18K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
64 |
64 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
80 |
67 |
$2K |