| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
7,786 |
7,139 |
$4.33M |
| D0999 |
Unspecified diagnostic procedure, by report |
469 |
424 |
$191K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,173 |
2,084 |
$200.98 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
657 |
655 |
$122.41 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
389 |
369 |
$1.02 |
| D0140 |
Limited oral evaluation - problem focused |
351 |
334 |
$0.66 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
743 |
701 |
$0.00 |
| D0330 |
Panoramic radiographic image |
42 |
42 |
$0.00 |
| 92015 |
Determination of refractive state |
305 |
304 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
110 |
106 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
138 |
133 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
140 |
132 |
$0.00 |
| D9999 |
Unspecified adjunctive procedure, by report |
111 |
79 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
204 |
200 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
263 |
251 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
167 |
163 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
80 |
79 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
66 |
65 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
27 |
27 |
$0.00 |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
60 |
59 |
$0.00 |
| 90688 |
|
47 |
47 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
95 |
95 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
39 |
39 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |