| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,237 |
1,214 |
$27K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
421 |
421 |
$21K |
| 92341 |
|
60 |
59 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
33 |
33 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
84 |
83 |
$384.00 |
| V2020 |
Frames, purchases |
1,520 |
1,492 |
$360.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,501 |
1,476 |
$108.00 |
| 92015 |
Determination of refractive state |
24 |
24 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
40 |
39 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
844 |
829 |
$0.00 |