| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
834 |
824 |
$50K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
741 |
736 |
$47K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,599 |
1,582 |
$45K |
| 92015 |
Determination of refractive state |
1,074 |
1,072 |
$39K |
| V2020 |
Frames, purchases |
1,355 |
1,331 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
909 |
901 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
174 |
171 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
278 |
273 |
$6K |