| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,165 |
4,083 |
$231K |
| V2020 |
Frames, purchases |
11,480 |
11,206 |
$199K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,564 |
5,407 |
$180K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,484 |
5,474 |
$86K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,067 |
1,051 |
$54K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,845 |
6,740 |
$46K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,647 |
1,645 |
$44K |
| 92341 |
|
2,357 |
2,340 |
$32K |
| 92015 |
Determination of refractive state |
7,159 |
7,145 |
$26K |
| V2300 |
Sphere, trifocal, plano to plus or minus 4.00d, per lens |
155 |
147 |
$13K |
| 3072F |
|
140 |
140 |
$0.00 |