| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
8,785 |
6,619 |
$525K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,041 |
3,046 |
$99K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,423 |
1,327 |
$67K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,762 |
1,689 |
$35K |
| D1110 |
Prophylaxis - adult |
121 |
59 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
51 |
27 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
13 |
$794.16 |
| 0011A |
|
21 |
21 |
$721.12 |
| 0012A |
|
16 |
16 |
$573.50 |
| 92551 |
|
164 |
88 |
$451.60 |
| 36415 |
Collection of venous blood by venipuncture |
464 |
309 |
$444.36 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
42 |
25 |
$217.50 |
| 36416 |
|
119 |
68 |
$190.69 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
14 |
$179.94 |
| 99173 |
|
139 |
75 |
$164.17 |
| 90686 |
|
34 |
28 |
$151.96 |
| 85018 |
|
177 |
104 |
$147.05 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
23 |
14 |
$136.24 |
| 81003 |
|
139 |
86 |
$113.13 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
16 |
13 |
$75.60 |
| 3008F |
|
2,367 |
2,165 |
$36.85 |
| D1206 |
Topical application of fluoride varnish |
30 |
24 |
$31.50 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
22 |
13 |
$6.08 |
| 2001F |
|
2,367 |
2,165 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
1,890 |
1,738 |
$0.00 |
| 3074F |
|
1,128 |
1,037 |
$0.00 |
| 3079F |
|
224 |
206 |
$0.00 |
| 1111F |
|
710 |
648 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
283 |
269 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
46 |
44 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
26 |
25 |
$0.00 |
| 3078F |
|
907 |
842 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
1,614 |
1,482 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
51 |
49 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
28 |
28 |
$0.00 |