| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,198 |
1,182 |
$54K |
| V2020 |
Frames, purchases |
1,555 |
1,526 |
$34K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
632 |
625 |
$28K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
686 |
666 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,079 |
1,073 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
477 |
474 |
$7K |
| 92015 |
Determination of refractive state |
142 |
136 |
$3K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
102 |
101 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$1K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
53 |
50 |
$805.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
298 |
295 |
$301.00 |
| V2025 |
Deluxe frame |
112 |
112 |
$0.00 |