| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,347 |
1,339 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
323 |
323 |
$18K |
| 92015 |
Determination of refractive state |
294 |
293 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
27 |
27 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$288.00 |
| V2020 |
Frames, purchases |
14 |
14 |
$275.00 |
| 3072F |
|
12 |
12 |
$0.00 |