| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,823 |
2,716 |
$37K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,276 |
2,195 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
855 |
790 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
525 |
485 |
$12K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
399 |
379 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,386 |
1,338 |
$10K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
186 |
181 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
209 |
188 |
$5K |
| 92015 |
Determination of refractive state |
164 |
138 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
29 |
13 |
$473.96 |