| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,527 |
1,194 |
$25K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
592 |
503 |
$25K |
| V2020 |
Frames, purchases |
1,469 |
1,239 |
$25K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
381 |
325 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,121 |
900 |
$13K |
| 92015 |
Determination of refractive state |
1,102 |
943 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
373 |
300 |
$4K |