| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
867 |
865 |
$42K |
| V2020 |
Frames, purchases |
1,368 |
1,331 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
661 |
317 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
58 |
58 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
52 |
26 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,612 |
783 |
$50.00 |
| 2026F |
|
12 |
12 |
$0.00 |