| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
546 |
538 |
$45K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
427 |
427 |
$33K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
995 |
558 |
$32K |
| V2020 |
Frames, purchases |
760 |
727 |
$24K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
809 |
771 |
$21K |
| 92250 |
|
191 |
188 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
630 |
603 |
$8K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
216 |
144 |
$8K |
| 92015 |
Determination of refractive state |
853 |
851 |
$6K |
| 92133 |
|
91 |
91 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$577.08 |