| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,983 |
4,250 |
$553K |
| D0999 |
Unspecified diagnostic procedure, by report |
192 |
129 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,174 |
1,914 |
$70.77 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,111 |
1,704 |
$33.22 |
| 81002 |
|
385 |
307 |
$2.03 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
293 |
225 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
94 |
78 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
42 |
25 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
26 |
26 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
398 |
338 |
$0.00 |