| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,564 |
1,269 |
$22K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
893 |
856 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
385 |
271 |
$5K |
| V2760 |
Scratch resistant coating, per lens |
476 |
243 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
33 |
30 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
222 |
210 |
$2K |
| 92015 |
Determination of refractive state |
93 |
77 |
$1K |
| V2025 |
Deluxe frame |
12 |
12 |
$515.26 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$284.15 |