| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
11,530 |
10,256 |
$1.90M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,231 |
2,112 |
$979.48 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,597 |
2,442 |
$303.88 |
| D1206 |
Topical application of fluoride varnish |
204 |
201 |
$242.76 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
28 |
28 |
$40.20 |
| 3078F |
|
14 |
12 |
$30.00 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
190 |
181 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
53 |
46 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
81 |
79 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
80 |
80 |
$0.00 |
| D1110 |
Prophylaxis - adult |
121 |
121 |
$0.00 |
| D1120 |
Prophylaxis - child |
160 |
156 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
51 |
51 |
$0.00 |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
16 |
16 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
40 |
40 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
15 |
15 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
98 |
98 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
212 |
208 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
39 |
39 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
30 |
30 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
28 |
28 |
$0.00 |