| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
615 |
615 |
$66K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
286 |
286 |
$36K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
784 |
783 |
$23K |
| 92015 |
Determination of refractive state |
1,138 |
1,138 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
506 |
506 |
$12K |
| V2020 |
Frames, purchases |
789 |
788 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
539 |
539 |
$0.00 |