| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
960 |
920 |
$83K |
| V2020 |
Frames, purchases |
1,453 |
1,387 |
$43K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
852 |
815 |
$40K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
329 |
319 |
$37K |
| 92015 |
Determination of refractive state |
1,546 |
1,488 |
$22K |
| V2755 |
U-v lens, per lens |
948 |
911 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
238 |
236 |
$12K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$1K |