| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 11721 |
|
1,992 |
1,977 |
$0.00 |
| 92015 |
Determination of refractive state |
403 |
402 |
$0.00 |
| D1110 |
Prophylaxis - adult |
346 |
344 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
146 |
140 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
678 |
672 |
$0.00 |
| V2020 |
Frames, purchases |
377 |
351 |
$0.00 |
| 11056 |
|
154 |
154 |
$0.00 |
| 92557 |
|
50 |
49 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
221 |
221 |
$0.00 |
| 11720 |
|
38 |
38 |
$0.00 |
| V5011 |
Fitting/orientation/checking of hearing aid |
62 |
60 |
$0.00 |
| D9951 |
|
20 |
12 |
$0.00 |
| V2756 |
Eye glass case |
381 |
336 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
34 |
34 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
370 |
334 |
$0.00 |
| D1330 |
|
353 |
345 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
355 |
355 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
145 |
143 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
544 |
528 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
380 |
335 |
$0.00 |
| 92250 |
|
77 |
77 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
355 |
355 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
130 |
32 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
98 |
98 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
142 |
141 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
35 |
35 |
$0.00 |
| 11055 |
|
12 |
12 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
23 |
18 |
$0.00 |
| D5899 |
|
16 |
12 |
$0.00 |