| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,709 |
1,401 |
$50K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
584 |
551 |
$49K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
739 |
633 |
$47K |
| V2020 |
Frames, purchases |
2,185 |
1,920 |
$28K |
| 92015 |
Determination of refractive state |
1,405 |
1,257 |
$16K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
831 |
800 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
747 |
613 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
84 |
80 |
$2K |