| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,251 |
2,246 |
$232K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,384 |
1,377 |
$109K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,426 |
2,392 |
$100K |
| V2020 |
Frames, purchases |
2,590 |
2,577 |
$86K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,172 |
2,167 |
$61K |
| V2025 |
Deluxe frame |
395 |
395 |
$23K |
| 92015 |
Determination of refractive state |
3,562 |
3,548 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,621 |
1,412 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
187 |
187 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
486 |
309 |
$3K |
| V2744 |
Tint, photochromatic, per lens |
437 |
435 |
$960.00 |
| V2750 |
Anti-reflective coating, per lens |
194 |
193 |
$0.00 |