| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
528 |
516 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
236 |
233 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
268 |
85 |
$7K |
| V2020 |
Frames, purchases |
225 |
150 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
263 |
259 |
$3K |
| 92015 |
Determination of refractive state |
565 |
556 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
436 |
151 |
$1K |
| V2760 |
Scratch resistant coating, per lens |
40 |
13 |
$400.00 |