| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,797 |
4,387 |
$263K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,657 |
4,148 |
$238K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
7,046 |
6,393 |
$185K |
| 92015 |
Determination of refractive state |
5,164 |
4,748 |
$176K |
| V2020 |
Frames, purchases |
6,353 |
5,693 |
$88K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,797 |
4,279 |
$86K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
361 |
356 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
410 |
368 |
$7K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
12 |
$119.00 |
| V2744 |
Tint, photochromatic, per lens |
14 |
13 |
$0.00 |
| 3072F |
|
20 |
20 |
$0.00 |