| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
248 |
247 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
258 |
254 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
34 |
32 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
32 |
31 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
28 |
$1K |
| 92015 |
Determination of refractive state |
85 |
84 |
$622.40 |
| V2020 |
Frames, purchases |
63 |
58 |
$602.00 |
| 92310 |
|
14 |
14 |
$343.90 |