| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
71 |
71 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
25 |
25 |
$2K |
| V2020 |
Frames, purchases |
73 |
73 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
18 |
18 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
67 |
66 |
$796.48 |
| 92015 |
Determination of refractive state |
85 |
85 |
$510.00 |