| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
34,676 |
28,712 |
$10.96M |
| G9012 |
Other specified case management service not elsewhere classified |
3,379 |
3,227 |
$779K |
| 0012A |
|
257 |
250 |
$7K |
| 0011A |
|
307 |
296 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,533 |
11,084 |
$3K |
| 3074F |
|
5,264 |
4,708 |
$1K |
| 0002A |
|
52 |
46 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,632 |
1,442 |
$1K |
| 0001A |
|
62 |
53 |
$1K |
| 3079F |
|
3,132 |
2,860 |
$1K |
| 3078F |
|
2,917 |
2,636 |
$760.32 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,160 |
1,969 |
$669.38 |
| 99499 |
|
628 |
595 |
$566.00 |
| 3077F |
|
620 |
576 |
$460.31 |
| 0013A |
|
30 |
27 |
$440.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,875 |
1,543 |
$351.20 |
| 99401 |
|
490 |
476 |
$289.00 |
| 3075F |
|
632 |
604 |
$270.21 |
| 87536 |
|
242 |
234 |
$208.96 |
| 3080F |
|
281 |
268 |
$130.18 |
| 36415 |
Collection of venous blood by venipuncture |
1,173 |
1,127 |
$112.00 |
| T1016 |
Case management, each 15 minutes |
12 |
12 |
$98.16 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
715 |
689 |
$43.75 |
| 98960 |
|
176 |
153 |
$38.25 |
| 82962 |
|
598 |
538 |
$16.20 |
| 80305 |
|
263 |
230 |
$11.80 |
| 81001 |
|
78 |
78 |
$2.70 |
| 80053 |
Comprehensive metabolic panel |
1,621 |
1,572 |
$0.35 |
| 80061 |
Lipid panel |
1,470 |
1,435 |
$0.27 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,080 |
1,059 |
$0.20 |
| 91301 |
|
229 |
220 |
$0.19 |
| 86592 |
|
623 |
613 |
$0.11 |
| 3008F |
|
3,315 |
2,880 |
$0.11 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
552 |
535 |
$0.10 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
665 |
647 |
$0.09 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
657 |
641 |
$0.09 |
| 1159F |
|
2,785 |
2,295 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
109 |
105 |
$0.00 |
| 1160F |
|
2,795 |
2,303 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
424 |
407 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
161 |
157 |
$0.00 |
| 82948 |
|
91 |
83 |
$0.00 |
| D0330 |
Panoramic radiographic image |
134 |
132 |
$0.00 |
| G9920 |
Screening performed and negative |
266 |
236 |
$0.00 |
| D1110 |
Prophylaxis - adult |
410 |
395 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
46 |
40 |
$0.00 |
| 91300 |
|
56 |
52 |
$0.00 |
| 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 |
65 |
61 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
41 |
41 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
31 |
25 |
$0.00 |
| D0270 |
|
27 |
27 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
17 |
15 |
$0.00 |
| 36416 |
|
607 |
552 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
382 |
363 |
$0.00 |
| 90686 |
|
261 |
261 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
557 |
545 |
$0.00 |
| D9995 |
|
145 |
132 |
$0.00 |
| D1330 |
|
508 |
489 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
215 |
154 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
545 |
481 |
$0.00 |
| T2022 |
Case management, per month |
190 |
169 |
$0.00 |
| D1310 |
|
388 |
382 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
108 |
81 |
$0.00 |
| D0603 |
|
180 |
171 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
260 |
80 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
257 |
255 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
136 |
133 |
$0.00 |
| 99172 |
|
14 |
14 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
123 |
122 |
$0.00 |
| 4010F |
|
46 |
28 |
$0.00 |