| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
16,603 |
11,478 |
$2.20M |
| H2020 |
Therapeutic behavioral services, per diem |
9,297 |
1,358 |
$246K |
| D0999 |
Unspecified diagnostic procedure, by report |
1,312 |
871 |
$125K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
5,651 |
3,005 |
$282.21 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,584 |
1,051 |
$165.52 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
411 |
324 |
$1.69 |
| D1110 |
Prophylaxis - adult |
97 |
70 |
$0.00 |
| 1160F |
|
2,464 |
1,952 |
$0.00 |
| 1159F |
|
2,467 |
1,954 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,495 |
1,081 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,485 |
3,910 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,431 |
2,735 |
$0.00 |
| 90461 |
|
405 |
275 |
$0.00 |
| 99177 |
|
2,063 |
1,591 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
7,234 |
1,055 |
$0.00 |
| 81002 |
|
1,720 |
1,239 |
$0.00 |
| 3078F |
|
3,747 |
2,913 |
$0.00 |
| 99188 |
|
1,536 |
1,067 |
$0.00 |
| 86703 |
|
507 |
266 |
$0.00 |
| D1120 |
Prophylaxis - child |
101 |
77 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
848 |
683 |
$0.00 |
| 90734 |
|
151 |
109 |
$0.00 |
| 96160 |
|
2,884 |
691 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,421 |
723 |
$0.00 |
| 90715 |
|
171 |
132 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
114 |
91 |
$0.00 |
| 99173 |
|
81 |
63 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
33 |
32 |
$0.00 |
| D0330 |
Panoramic radiographic image |
84 |
84 |
$0.00 |
| D1999 |
|
65 |
65 |
$0.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
40 |
39 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
6,676 |
4,287 |
$0.00 |
| 3008F |
|
3,731 |
2,507 |
$0.00 |
| 96127 |
|
6,261 |
3,625 |
$0.00 |
| 1036F |
|
4,431 |
3,357 |
$0.00 |
| 1000F |
|
1,466 |
1,080 |
$0.00 |
| 92551 |
|
1,625 |
1,363 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,405 |
6,441 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
230 |
185 |
$0.00 |
| 85018 |
|
2,118 |
1,488 |
$0.00 |
| 3074F |
|
3,862 |
2,979 |
$0.00 |
| 1126F |
|
1,117 |
968 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
843 |
723 |
$0.00 |
| 1125F |
|
2,722 |
2,168 |
$0.00 |
| 99000 |
|
1,712 |
1,105 |
$0.00 |
| 99383 |
|
18 |
16 |
$0.00 |
| 3079F |
|
77 |
66 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
65 |
65 |
$0.00 |
| 90686 |
|
116 |
90 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
227 |
114 |
$0.00 |
| H0033 |
Oral medication administration, direct observation |
43 |
43 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
45 |
45 |
$0.00 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
40 |
35 |
$0.00 |
| 90651 |
|
202 |
165 |
$0.00 |
| A9150 |
Non-prescription drugs |
65 |
54 |
$0.00 |
| 3075F |
|
46 |
42 |
$0.00 |
| 96161 |
|
13 |
13 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
13 |
13 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
93 |
72 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
32 |
25 |
$0.00 |
| 82962 |
|
16 |
16 |
$0.00 |