| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0659 |
Rehabilitation services, other |
132 |
69 |
$291K |
| 0650 |
Inj, levothyroxine, hikma |
13 |
13 |
$60K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,331 |
1,234 |
$21K |
| V2020 |
Frames, purchases |
1,428 |
1,351 |
$19K |
| 67938 |
|
88 |
68 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
881 |
815 |
$11K |
| 99215 |
Prolong outpt/office vis |
160 |
160 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
218 |
218 |
$6K |
| 92015 |
Determination of refractive state |
874 |
874 |
$4K |
| 92341 |
|
186 |
186 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
122 |
122 |
$3K |