| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,292 |
1,191 |
$139K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,209 |
1,756 |
$82K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
894 |
841 |
$81K |
| V2020 |
Frames, purchases |
2,313 |
1,990 |
$55K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
810 |
740 |
$12K |
| 92015 |
Determination of refractive state |
2,394 |
2,210 |
$12K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
21 |
14 |
$730.66 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
336 |
274 |
$150.00 |
| V2025 |
Deluxe frame |
17 |
15 |
$0.00 |