| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
14,898 |
12,832 |
$301K |
| D5110 |
|
763 |
716 |
$292K |
| D5120 |
|
701 |
665 |
$275K |
| D1110 |
Prophylaxis - adult |
6,386 |
5,451 |
$226K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
6,165 |
5,287 |
$156K |
| 11721 |
|
42,859 |
24,258 |
$154K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,150 |
2,476 |
$120K |
| 92015 |
Determination of refractive state |
8,959 |
6,445 |
$88K |
| V2020 |
Frames, purchases |
4,474 |
3,545 |
$63K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,595 |
2,498 |
$61K |
| 11720 |
|
16,101 |
10,054 |
$52K |
| D4341 |
|
239 |
140 |
$49K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,015 |
2,541 |
$48K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,342 |
1,654 |
$33K |
| G0127 |
Trimming of dystrophic nails, any number |
12,585 |
6,779 |
$27K |
| 92557 |
|
7,695 |
5,308 |
$24K |
| D0140 |
Limited oral evaluation - problem focused |
653 |
547 |
$21K |
| V5241 |
Dispensing fee, monaural hearing aid, any type |
185 |
148 |
$20K |
| 92002 |
|
1,215 |
838 |
$16K |
| D0170 |
|
829 |
740 |
$14K |
| V5060 |
Hearing aid, monaural, behind the ear |
43 |
39 |
$14K |
| 69210 |
|
1,939 |
929 |
$14K |
| 99307 |
|
4,177 |
2,030 |
$12K |
| 11719 |
|
6,491 |
4,483 |
$9K |
| D0210 |
Intraoral - complete series of radiographic images |
198 |
156 |
$8K |
| 92567 |
|
7,080 |
5,012 |
$7K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
250 |
194 |
$7K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
784 |
387 |
$6K |
| 92250 |
|
605 |
463 |
$6K |
| D4355 |
|
73 |
62 |
$5K |
| 11055 |
|
1,397 |
783 |
$5K |
| 11730 |
|
650 |
259 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
149 |
109 |
$4K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
1,587 |
653 |
$4K |
| 99304 |
|
661 |
304 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
421 |
73 |
$3K |
| 92556 |
|
1,289 |
882 |
$3K |
| V5050 |
Hearing aid, monaural, in the ear |
14 |
13 |
$3K |
| 92552 |
|
702 |
526 |
$2K |
| V5264 |
Ear mold/insert, not disposable, any type |
35 |
28 |
$945.00 |
| 11056 |
|
302 |
161 |
$885.27 |
| D0220 |
Intraoral - periapical first radiographic image |
115 |
90 |
$861.25 |
| 97597 |
|
258 |
93 |
$833.33 |
| V5266 |
Battery for use in hearing device |
71 |
71 |
$710.00 |
| 11740 |
|
74 |
46 |
$350.66 |
| 99334 |
|
37 |
29 |
$350.63 |
| 99324 |
|
107 |
41 |
$306.71 |
| 92550 |
|
163 |
64 |
$167.69 |
| 92553 |
|
198 |
99 |
$127.15 |
| 92555 |
|
110 |
73 |
$83.85 |
| G8405 |
Lower extremity neurological exam not performed |
128 |
95 |
$0.00 |
| G0245 |
Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of a protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear and (4) patient education |
66 |
45 |
$0.00 |
| 99305 |
|
42 |
12 |
$0.00 |
| G8404 |
Lower extremity neurological exam performed and documented |
894 |
632 |
$0.00 |
| G0247 |
Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails |
194 |
155 |
$0.00 |
| D5411 |
|
78 |
59 |
$0.00 |
| G8415 |
Footwear evaluation was not performed |
107 |
71 |
$0.00 |
| G0246 |
Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education |
79 |
67 |
$0.00 |
| 92341 |
|
28 |
12 |
$0.00 |