| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,064 |
1,284 |
$34K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,659 |
1,124 |
$21K |
| V2020 |
Frames, purchases |
2,013 |
1,354 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
466 |
335 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,232 |
881 |
$8K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
64 |
16 |
$377.00 |
| 92015 |
Determination of refractive state |
1,527 |
1,054 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
464 |
299 |
$0.00 |