| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
255 |
218 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
199 |
156 |
$8K |
| 92015 |
Determination of refractive state |
675 |
557 |
$3K |
| V2020 |
Frames, purchases |
101 |
74 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
86 |
59 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
30 |
15 |
$279.25 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
77 |
75 |
$270.00 |