| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
292 |
290 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
586 |
582 |
$22K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
277 |
274 |
$19K |
| V2020 |
Frames, purchases |
396 |
390 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
207 |
207 |
$6K |
| 92015 |
Determination of refractive state |
625 |
622 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
175 |
174 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$780.15 |