| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
723 |
722 |
$63K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
691 |
691 |
$51K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
867 |
863 |
$39K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,618 |
1,611 |
$33K |
| V2025 |
Deluxe frame |
414 |
414 |
$27K |
| V2020 |
Frames, purchases |
1,024 |
1,022 |
$21K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
238 |
238 |
$17K |
| 92015 |
Determination of refractive state |
1,608 |
1,605 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
139 |
139 |
$1K |