| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
55,290 |
31,977 |
$25.31M |
| D9999 |
Unspecified adjunctive procedure, by report |
2,734 |
1,745 |
$750K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,613 |
13,761 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,165 |
1,141 |
$77.36 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
500 |
478 |
$55.89 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,782 |
2,252 |
$0.00 |
| D1330 |
|
1,088 |
825 |
$0.00 |
| 91307 |
|
621 |
356 |
$0.00 |
| 0001A |
|
245 |
243 |
$0.00 |
| 87081 |
|
96 |
67 |
$0.00 |
| 81015 |
|
172 |
133 |
$0.00 |
| 91301 |
|
177 |
172 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
1,671 |
949 |
$0.00 |
| 90686 |
|
377 |
320 |
$0.00 |
| 99172 |
|
136 |
136 |
$0.00 |
| D1351 |
Sealant - per tooth |
3,966 |
259 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
766 |
702 |
$0.00 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
63 |
62 |
$0.00 |
| D1310 |
|
79 |
61 |
$0.00 |
| 0012A |
|
89 |
89 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
101 |
79 |
$0.00 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
44 |
39 |
$0.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
137 |
107 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
31 |
31 |
$0.00 |
| 91303 |
|
41 |
25 |
$0.00 |
| 0031A |
|
13 |
13 |
$0.00 |
| 91305 |
|
15 |
14 |
$0.00 |
| 0011A |
|
86 |
82 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
38 |
28 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$0.00 |
| D0000 |
|
16 |
16 |
$0.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
358 |
330 |
$0.00 |
| 91300 |
|
1,188 |
770 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
704 |
647 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
220 |
214 |
$0.00 |
| D0191 |
|
875 |
483 |
$0.00 |
| 81003 |
|
734 |
548 |
$0.00 |
| D1120 |
Prophylaxis - child |
241 |
125 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
157 |
62 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
248 |
175 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
178 |
175 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
180 |
180 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
17 |
17 |
$0.00 |
| 0002A |
|
248 |
232 |
$0.00 |
| 92015 |
Determination of refractive state |
76 |
36 |
$0.00 |
| 90672 |
|
14 |
14 |
$0.00 |
| 85014 |
|
139 |
112 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
150 |
143 |
$0.00 |
| 83655 |
|
12 |
12 |
$0.00 |
| 80061 |
Lipid panel |
14 |
14 |
$0.00 |
| D0190 |
|
40 |
33 |
$0.00 |