| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,829 |
1,797 |
$89K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,150 |
1,137 |
$61K |
| V2020 |
Frames, purchases |
4,257 |
4,190 |
$45K |
| 92015 |
Determination of refractive state |
3,328 |
3,285 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,631 |
1,602 |
$29K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,019 |
3,959 |
$27K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
853 |
841 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,321 |
1,301 |
$24K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
111 |
111 |
$2K |