| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,107 |
1,088 |
$87K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
637 |
634 |
$52K |
| V2020 |
Frames, purchases |
1,651 |
1,626 |
$42K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
922 |
888 |
$41K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
750 |
743 |
$18K |
| 92002 |
|
215 |
211 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
106 |
102 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
77 |
76 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
136 |
135 |
$177.44 |
| 3072F |
|
16 |
16 |
$0.00 |