| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
9,860 |
6,383 |
$887K |
| D0999 |
Unspecified diagnostic procedure, by report |
5,579 |
3,354 |
$339K |
| D0210 |
Intraoral - complete series of radiographic images |
1,122 |
772 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,313 |
509 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,327 |
930 |
$1K |
| D1110 |
Prophylaxis - adult |
369 |
283 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
217 |
150 |
$36.15 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,762 |
3,683 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,248 |
985 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
443 |
346 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
444 |
337 |
$0.00 |
| 86592 |
|
498 |
395 |
$0.00 |
| 90688 |
|
14 |
14 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
82 |
59 |
$0.00 |
| D1330 |
|
468 |
334 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
593 |
390 |
$0.00 |
| 86317 |
|
48 |
46 |
$0.00 |
| 3351F |
|
561 |
443 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
498 |
394 |
$0.00 |
| 82962 |
|
264 |
180 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
216 |
170 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
58 |
40 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
184 |
148 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
55 |
42 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
421 |
331 |
$0.00 |
| 86706 |
|
30 |
26 |
$0.00 |
| 86580 |
|
18 |
12 |
$0.00 |
| 90636 |
|
21 |
12 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
21 |
14 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
78 |
39 |
$0.00 |
| 81002 |
|
241 |
187 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
169 |
155 |
$0.00 |
| 86703 |
|
56 |
31 |
$0.00 |
| G0121 |
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk |
188 |
170 |
$0.00 |
| 86709 |
|
474 |
374 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
132 |
93 |
$0.00 |
| D0330 |
Panoramic radiographic image |
102 |
59 |
$0.00 |
| 80305 |
|
341 |
202 |
$0.00 |
| 83718 |
|
116 |
89 |
$0.00 |
| 82948 |
|
38 |
24 |
$0.00 |
| 90658 |
|
55 |
35 |
$0.00 |
| 99408 |
|
63 |
39 |
$0.00 |
| 80061 |
Lipid panel |
61 |
58 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
23 |
17 |
$0.00 |
| 83037 |
|
19 |
13 |
$0.00 |