| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
37 |
37 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
22 |
22 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
35 |
34 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
39 |
38 |
$975.00 |
| V2020 |
Frames, purchases |
41 |
40 |
$492.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
27 |
26 |
$399.75 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$156.00 |