| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
64,373 |
48,080 |
$19.23M |
| 0001A |
|
539 |
535 |
$2K |
| 0002A |
|
521 |
517 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,077 |
18,067 |
$505.36 |
| 0012A |
|
60 |
60 |
$480.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,509 |
2,264 |
$262.53 |
| 0011A |
|
103 |
103 |
$240.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,937 |
2,647 |
$159.17 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,300 |
6,751 |
$85.32 |
| 0071A |
|
350 |
336 |
$46.00 |
| 92551 |
|
5,228 |
4,759 |
$41.64 |
| 99173 |
|
5,099 |
4,639 |
$34.96 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,330 |
1,164 |
$21.33 |
| 90686 |
|
2,541 |
2,202 |
$4.94 |
| 36415 |
Collection of venous blood by venipuncture |
2,271 |
2,036 |
$0.00 |
| 97802 |
|
1,213 |
1,139 |
$0.00 |
| 99000 |
|
3,364 |
3,043 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,318 |
1,090 |
$0.00 |
| 3074F |
|
3,761 |
3,439 |
$0.00 |
| 99381 |
|
456 |
416 |
$0.00 |
| 3008F |
|
5,461 |
4,838 |
$0.00 |
| 90680 |
|
431 |
415 |
$0.00 |
| 90651 |
|
750 |
662 |
$0.00 |
| D1310 |
|
1,210 |
1,025 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
2,315 |
2,066 |
$0.00 |
| 2001F |
|
5,326 |
4,708 |
$0.00 |
| D1330 |
|
1,298 |
1,085 |
$0.00 |
| 1126F |
|
3,617 |
3,301 |
$0.00 |
| A9150 |
Non-prescription drugs |
95 |
61 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
375 |
297 |
$0.00 |
| 90620 |
|
239 |
230 |
$0.00 |
| 96161 |
|
217 |
179 |
$0.00 |
| 85018 |
|
1,077 |
952 |
$0.00 |
| 0072A |
|
278 |
272 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,940 |
10,195 |
$0.00 |
| 36416 |
|
398 |
366 |
$0.00 |
| 90619 |
|
298 |
287 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
118 |
108 |
$0.00 |
| 96156 |
|
510 |
472 |
$0.00 |
| 87807 |
|
280 |
245 |
$0.00 |
| 1036F |
|
3,210 |
2,830 |
$0.00 |
| 0111A |
|
33 |
32 |
$0.00 |
| 90697 |
|
102 |
98 |
$0.00 |
| 90480 |
|
112 |
112 |
$0.00 |
| 1125F |
|
552 |
524 |
$0.00 |
| 90698 |
|
104 |
103 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,110 |
904 |
$0.00 |
| 0154A |
|
25 |
12 |
$0.00 |
| 96150 |
|
660 |
484 |
$0.00 |
| 0112A |
|
12 |
12 |
$0.00 |
| 90688 |
|
251 |
231 |
$0.00 |
| 87428 |
|
617 |
450 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
27 |
27 |
$0.00 |
| 96151 |
|
12 |
12 |
$0.00 |
| 82962 |
|
14 |
14 |
$0.00 |
| 86580 |
|
48 |
48 |
$0.00 |
| 90723 |
|
201 |
186 |
$0.00 |
| 90696 |
|
111 |
111 |
$0.00 |
| 0081A |
|
28 |
25 |
$0.00 |
| 0074A |
|
90 |
72 |
$0.00 |
| 90716 |
|
65 |
63 |
$0.00 |
| 91307 |
|
16 |
15 |
$0.00 |
| 91301 |
|
150 |
150 |
$0.00 |
| 82150 |
|
35 |
26 |
$0.00 |
| 82040 |
|
35 |
26 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
21 |
18 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
86 |
67 |
$0.00 |
| 84075 |
|
35 |
26 |
$0.00 |
| 90656 |
|
320 |
304 |
$0.00 |
| 1111F |
|
32 |
31 |
$0.00 |
| 3079F |
|
13 |
12 |
$0.00 |
| 96380 |
|
15 |
14 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
13 |
12 |
$0.00 |
| 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 |
12 |
12 |
$0.00 |
| 3078F |
|
3,648 |
3,344 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,694 |
3,319 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,282 |
2,045 |
$0.00 |
| D0190 |
|
2,193 |
1,954 |
$0.00 |
| 96167 |
|
718 |
640 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,285 |
1,952 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,728 |
2,245 |
$0.00 |
| D9996 |
|
2,276 |
2,027 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
3,530 |
3,334 |
$0.00 |
| 90633 |
|
626 |
588 |
$0.00 |
| 90670 |
|
586 |
532 |
$0.00 |
| 84155 |
|
35 |
26 |
$0.00 |
| 90671 |
|
658 |
633 |
$0.00 |
| 90710 |
|
104 |
104 |
$0.00 |
| 90681 |
|
130 |
124 |
$0.00 |
| 90715 |
|
179 |
172 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
164 |
155 |
$0.00 |
| 81025 |
|
77 |
74 |
$0.00 |
| 1159F |
|
4,585 |
4,071 |
$0.00 |
| 83655 |
|
797 |
717 |
$0.00 |
| 90707 |
|
38 |
37 |
$0.00 |
| 99177 |
|
492 |
447 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
82 |
55 |
$0.00 |
| 81002 |
|
585 |
442 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
108 |
98 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
162 |
160 |
$0.00 |
| 90734 |
|
186 |
178 |
$0.00 |
| 82247 |
|
35 |
26 |
$0.00 |
| 90648 |
|
395 |
365 |
$0.00 |
| 97803 |
|
679 |
637 |
$0.00 |
| 91312 |
|
50 |
42 |
$0.00 |
| 81003 |
|
478 |
433 |
$0.00 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
32 |
29 |
$0.00 |
| 82977 |
|
34 |
26 |
$0.00 |
| 0004A |
|
99 |
96 |
$0.00 |
| 84460 |
|
36 |
27 |
$0.00 |
| 0054A |
|
119 |
101 |
$0.00 |
| 90700 |
|
57 |
57 |
$0.00 |
| 84450 |
|
36 |
27 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
35 |
35 |
$0.00 |
| 91300 |
|
855 |
788 |
$0.00 |
| 0124A |
|
126 |
102 |
$0.00 |
| 90685 |
|
56 |
55 |
$0.00 |
| 99188 |
|
38 |
28 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$0.00 |
| 90687 |
|
16 |
16 |
$0.00 |