| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
669 |
663 |
$49K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
506 |
498 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
794 |
785 |
$30K |
| V2020 |
Frames, purchases |
889 |
876 |
$16K |
| 92015 |
Determination of refractive state |
1,337 |
1,318 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
446 |
445 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
72 |
66 |
$632.58 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$121.60 |