| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
48,086 |
41,196 |
$10.64M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,217 |
10,249 |
$16K |
| 0071A |
|
316 |
313 |
$10K |
| 0002A |
|
256 |
250 |
$10K |
| 0072A |
|
236 |
235 |
$9K |
| 0001A |
|
239 |
233 |
$8K |
| 99499 |
|
727 |
669 |
$8K |
| 0012A |
|
194 |
191 |
$7K |
| 0011A |
|
227 |
227 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
981 |
973 |
$3K |
| 0124A |
|
130 |
129 |
$2K |
| 0064A |
|
55 |
55 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,955 |
3,903 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
59 |
57 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,125 |
1,074 |
$1K |
| 90480 |
|
42 |
41 |
$794.22 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,222 |
1,214 |
$741.73 |
| 0031A |
|
20 |
20 |
$733.00 |
| 0003A |
|
17 |
17 |
$680.00 |
| 0053A |
|
43 |
43 |
$640.00 |
| 90686 |
|
2,425 |
2,401 |
$567.86 |
| 0052A |
|
14 |
14 |
$520.00 |
| 0081A |
|
36 |
36 |
$500.00 |
| 0082A |
|
14 |
14 |
$480.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,178 |
3,832 |
$375.50 |
| 92551 |
|
2,403 |
2,382 |
$349.57 |
| 0073A |
|
45 |
45 |
$240.00 |
| 99173 |
|
2,232 |
2,215 |
$165.82 |
| 0154A |
|
17 |
17 |
$140.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,142 |
2,129 |
$59.09 |
| 92015 |
Determination of refractive state |
54 |
52 |
$24.50 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
463 |
461 |
$24.00 |
| 90656 |
|
267 |
266 |
$22.35 |
| 90461 |
|
993 |
985 |
$20.72 |
| 90633 |
|
249 |
249 |
$10.00 |
| 36415 |
Collection of venous blood by venipuncture |
2,241 |
2,190 |
$8.43 |
| D1330 |
|
815 |
813 |
$0.00 |
| 90696 |
|
25 |
25 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
755 |
753 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
930 |
917 |
$0.00 |
| 96127 |
|
66 |
65 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
1,087 |
1,087 |
$0.00 |
| 90651 |
|
590 |
590 |
$0.00 |
| D0603 |
|
353 |
352 |
$0.00 |
| 90620 |
|
115 |
114 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
67 |
67 |
$0.00 |
| 90723 |
|
53 |
53 |
$0.00 |
| 90647 |
|
101 |
101 |
$0.00 |
| D0602 |
|
226 |
226 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
60 |
56 |
$0.00 |
| 90716 |
|
13 |
13 |
$0.00 |
| 90677 |
|
18 |
18 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
28 |
28 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12 |
12 |
$0.00 |
| 90670 |
|
184 |
184 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
212 |
208 |
$0.00 |
| D1120 |
Prophylaxis - child |
585 |
577 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
308 |
306 |
$0.00 |
| D1110 |
Prophylaxis - adult |
390 |
388 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,208 |
1,205 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
1,089 |
1,089 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
87 |
83 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
77 |
77 |
$0.00 |
| D0330 |
Panoramic radiographic image |
142 |
141 |
$0.00 |
| 90734 |
|
297 |
297 |
$0.00 |
| D1999 |
|
312 |
261 |
$0.00 |
| 83655 |
|
214 |
212 |
$0.00 |
| 90715 |
|
105 |
105 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
142 |
140 |
$0.00 |
| 90710 |
|
42 |
42 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
43 |
43 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 90700 |
|
21 |
21 |
$0.00 |