| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
8,720 |
6,985 |
$1.63M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28,599 |
23,404 |
$460K |
| D0120 |
Periodic oral evaluation - established patient |
846 |
735 |
$83K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,197 |
6,648 |
$62K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,022 |
1,852 |
$54K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,218 |
3,712 |
$47K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,826 |
1,491 |
$44K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,290 |
2,079 |
$42K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,182 |
1,098 |
$34K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,023 |
851 |
$20K |
| 90671 |
|
491 |
394 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,170 |
1,033 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,273 |
1,192 |
$18K |
| 90697 |
|
315 |
262 |
$16K |
| 92551 |
|
3,854 |
3,623 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,011 |
935 |
$14K |
| 90686 |
|
1,166 |
1,017 |
$6K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,058 |
877 |
$6K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
9,998 |
8,818 |
$6K |
| 90651 |
|
135 |
109 |
$6K |
| 99173 |
|
4,046 |
3,811 |
$5K |
| 99401 |
|
4,061 |
3,539 |
$5K |
| 81025 |
|
1,560 |
1,225 |
$3K |
| 81002 |
|
8,273 |
6,128 |
$2K |
| 90619 |
|
23 |
21 |
$2K |
| 97802 |
|
3,563 |
3,068 |
$2K |
| 90734 |
|
34 |
34 |
$2K |
| 90658 |
|
105 |
89 |
$1K |
| 0011A |
|
30 |
30 |
$1K |
| 90633 |
|
359 |
297 |
$982.12 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
417 |
384 |
$955.02 |
| 0012A |
|
23 |
23 |
$926.27 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
61 |
54 |
$912.23 |
| 88142 |
|
30 |
30 |
$836.00 |
| 90698 |
|
107 |
92 |
$822.38 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
38 |
29 |
$723.04 |
| 90474 |
|
58 |
49 |
$538.07 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
157 |
157 |
$517.41 |
| 90670 |
|
256 |
210 |
$480.00 |
| 97803 |
|
2,943 |
2,530 |
$479.37 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
78 |
55 |
$463.49 |
| 90716 |
|
46 |
39 |
$420.00 |
| 90681 |
|
59 |
50 |
$395.60 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
280 |
244 |
$345.03 |
| 90688 |
|
344 |
291 |
$272.93 |
| 82962 |
|
424 |
342 |
$237.56 |
| D0210 |
Intraoral - complete series of radiographic images |
43 |
43 |
$189.75 |
| 90685 |
|
26 |
26 |
$121.55 |
| D1206 |
Topical application of fluoride varnish |
180 |
179 |
$100.00 |
| D1120 |
Prophylaxis - child |
138 |
136 |
$93.75 |
| D1110 |
Prophylaxis - adult |
351 |
326 |
$93.75 |
| 90707 |
|
16 |
12 |
$87.62 |
| 96380 |
|
39 |
26 |
$61.14 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
67 |
67 |
$50.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
30 |
29 |
$42.00 |
| D0220 |
Intraoral - periapical first radiographic image |
866 |
794 |
$19.50 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12 |
12 |
$16.83 |
| D1330 |
|
55 |
46 |
$0.00 |
| D1310 |
|
14 |
14 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,430 |
455 |
$0.00 |
| 99000 |
|
883 |
738 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
24 |
24 |
$0.00 |
| 0503F |
|
25 |
14 |
$0.00 |
| G9273 |
Blood pressure has a systolic value of < 140 and a diastolic value of < 90 |
12 |
12 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |
| D0601 |
|
13 |
13 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
191 |
182 |
$0.00 |
| D0190 |
|
661 |
512 |
$0.00 |
| 90649 |
|
68 |
65 |
$0.00 |
| 98970 |
|
15 |
15 |
$0.00 |