| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
684 |
572 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
606 |
516 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
483 |
405 |
$8K |
| V2020 |
Frames, purchases |
707 |
595 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
75 |
66 |
$1K |
| 92015 |
Determination of refractive state |
523 |
433 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
203 |
160 |
$0.00 |