| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
39,368 |
15,174 |
$16.52M |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$7K |
| 99215 |
Prolong outpt/office vis |
247 |
225 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
231 |
226 |
$0.00 |
| 91300 |
|
192 |
90 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
171 |
170 |
$0.00 |
| 92015 |
Determination of refractive state |
247 |
242 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
43 |
30 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
269 |
237 |
$0.00 |
| V2020 |
Frames, purchases |
193 |
192 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
13 |
$0.00 |
| 81003 |
|
109 |
99 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
170 |
168 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
204 |
115 |
$0.00 |
| D0330 |
Panoramic radiographic image |
25 |
25 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
38 |
33 |
$0.00 |
| 82948 |
|
189 |
174 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
14 |
$0.00 |
| 80306 |
|
22 |
16 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
655 |
412 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
108 |
105 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
91 |
91 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
385 |
350 |
$0.00 |
| 36416 |
|
71 |
65 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
259 |
226 |
$0.00 |
| V2755 |
U-v lens, per lens |
177 |
175 |
$0.00 |
| 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 |
595 |
407 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
420 |
370 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
24 |
24 |
$0.00 |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
135 |
105 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
25 |
24 |
$0.00 |
| 0064A |
|
150 |
63 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
45 |
44 |
$0.00 |
| 91306 |
|
144 |
62 |
$0.00 |
| 90686 |
|
252 |
155 |
$0.00 |
| 0001A |
|
135 |
67 |
$0.00 |
| D1330 |
|
87 |
80 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
29 |
28 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
86 |
81 |
$0.00 |
| 87807 |
|
13 |
13 |
$0.00 |
| 90688 |
|
57 |
37 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
15 |
15 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
31 |
15 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$0.00 |