| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,877 |
2,869 |
$298K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,306 |
2,303 |
$72K |
| 92015 |
Determination of refractive state |
1,724 |
1,724 |
$26K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
578 |
577 |
$25K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
391 |
391 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
233 |
233 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
786 |
784 |
$9K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
56 |
56 |
$4K |