| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,431 |
1,377 |
$58K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,275 |
591 |
$35K |
| V2020 |
Frames, purchases |
1,036 |
947 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
133 |
124 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
231 |
110 |
$1K |
| 92015 |
Determination of refractive state |
388 |
366 |
$666.30 |
| V2750 |
Anti-reflective coating, per lens |
34 |
14 |
$165.00 |
| V2760 |
Scratch resistant coating, per lens |
102 |
45 |
$0.00 |