| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
47,541 |
42,180 |
$7.15M |
| 0012A |
|
472 |
456 |
$16K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
891 |
847 |
$11K |
| 0011A |
|
493 |
470 |
$10K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
81 |
81 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,118 |
10,445 |
$2K |
| 0064A |
|
173 |
167 |
$2K |
| 3078F |
|
102 |
99 |
$775.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,960 |
10,434 |
$628.16 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
34 |
34 |
$585.40 |
| 3074F |
|
137 |
136 |
$475.00 |
| 3044F |
|
139 |
137 |
$475.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,509 |
2,426 |
$376.94 |
| 3077F |
|
160 |
157 |
$325.00 |
| 3079F |
|
167 |
166 |
$325.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
362 |
362 |
$120.63 |
| 90461 |
|
1,244 |
1,211 |
$69.42 |
| 90686 |
|
969 |
881 |
$45.30 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,204 |
3,113 |
$44.84 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
333 |
328 |
$30.35 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,165 |
2,119 |
$14.70 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
590 |
585 |
$14.05 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
675 |
611 |
$9.07 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
698 |
695 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
952 |
948 |
$0.00 |
| D1110 |
Prophylaxis - adult |
815 |
808 |
$0.00 |
| D1999 |
|
326 |
322 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
558 |
550 |
$0.00 |
| D1120 |
Prophylaxis - child |
113 |
113 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
56 |
55 |
$0.00 |
| 90734 |
|
82 |
81 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
17 |
17 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
190 |
189 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
330 |
319 |
$0.00 |
| 81002 |
|
63 |
61 |
$0.00 |
| 99173 |
|
435 |
433 |
$0.00 |
| 90715 |
|
87 |
87 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
30 |
30 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
26 |
21 |
$0.00 |
| D0330 |
Panoramic radiographic image |
15 |
15 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
12 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
33 |
33 |
$0.00 |
| 92551 |
|
689 |
686 |
$0.00 |
| 90656 |
|
59 |
59 |
$0.00 |
| 3080F |
|
62 |
61 |
$0.00 |
| 90647 |
|
56 |
55 |
$0.00 |
| 85018 |
|
51 |
51 |
$0.00 |
| 91306 |
|
127 |
110 |
$0.00 |
| 90651 |
|
72 |
72 |
$0.00 |
| 91301 |
|
442 |
403 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
170 |
170 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
14 |
13 |
$0.00 |
| 3075F |
|
29 |
29 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
201 |
199 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
50 |
50 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |