| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
16,303 |
9,726 |
$1.79M |
| H2020 |
Therapeutic behavioral services, per diem |
4,609 |
1,861 |
$420K |
| D0999 |
Unspecified diagnostic procedure, by report |
2,340 |
1,567 |
$200K |
| 3074F |
|
623 |
435 |
$35.00 |
| 3079F |
|
169 |
148 |
$25.00 |
| 3078F |
|
469 |
304 |
$25.00 |
| 87428 |
|
195 |
140 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
780 |
740 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,189 |
581 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,260 |
3,424 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
895 |
800 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
275 |
206 |
$0.00 |
| 3008F |
|
1,486 |
1,086 |
$0.00 |
| 1036F |
|
602 |
389 |
$0.00 |
| 2001F |
|
1,592 |
1,159 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
150 |
118 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
951 |
782 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
163 |
161 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
358 |
165 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
286 |
226 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
57 |
44 |
$0.00 |
| 1111F |
|
230 |
188 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
140 |
115 |
$0.00 |
| 92551 |
|
104 |
92 |
$0.00 |
| 99172 |
|
22 |
22 |
$0.00 |
| 99174 |
|
155 |
151 |
$0.00 |
| D0603 |
|
22 |
21 |
$0.00 |
| 1125F |
|
135 |
119 |
$0.00 |
| D0602 |
|
52 |
51 |
$0.00 |
| 85018 |
|
31 |
12 |
$0.00 |
| 90686 |
|
168 |
134 |
$0.00 |
| 1126F |
|
215 |
166 |
$0.00 |
| 1034F |
|
15 |
12 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
30 |
14 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
815 |
516 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
276 |
198 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,582 |
1,959 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,625 |
1,819 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
2,875 |
1,087 |
$0.00 |
| 1159F |
|
200 |
171 |
$0.00 |
| 81003 |
|
388 |
190 |
$0.00 |
| 99177 |
|
416 |
355 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
876 |
246 |
$0.00 |
| D1120 |
Prophylaxis - child |
943 |
857 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
140 |
70 |
$0.00 |
| 90473 |
|
56 |
54 |
$0.00 |
| 90672 |
|
100 |
92 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
29 |
13 |
$0.00 |
| 96160 |
|
121 |
91 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
346 |
263 |
$0.00 |
| 4004F |
|
50 |
43 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
35 |
24 |
$0.00 |
| 99173 |
|
61 |
43 |
$0.00 |
| 82947 |
|
34 |
13 |
$0.00 |
| 3077F |
|
29 |
24 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
16 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
16 |
12 |
$0.00 |