| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,269 |
2,269 |
$166K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
843 |
843 |
$64K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
738 |
738 |
$28K |
| V2020 |
Frames, purchases |
866 |
865 |
$15K |
| 92015 |
Determination of refractive state |
3,137 |
3,133 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
260 |
260 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
116 |
116 |
$1K |