| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,804 |
1,760 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,368 |
1,330 |
$26K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
680 |
662 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
454 |
442 |
$17K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
371 |
364 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
686 |
669 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
69 |
68 |
$2K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
41 |
41 |
$2K |