| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,324 |
3,742 |
$678K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,622 |
4,039 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,909 |
5,217 |
$7K |
| D1120 |
Prophylaxis - child |
223 |
221 |
$4K |
| D1206 |
Topical application of fluoride varnish |
222 |
219 |
$2K |
| D1310 |
|
83 |
83 |
$1K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
244 |
204 |
$940.02 |
| D0603 |
|
12 |
12 |
$90.00 |
| 99000 |
|
482 |
459 |
$89.86 |
| 92552 |
|
437 |
437 |
$47.29 |
| 81000 |
|
728 |
718 |
$36.12 |
| D1330 |
|
214 |
210 |
$25.00 |
| 92553 |
|
12 |
12 |
$22.26 |
| 85018 |
|
87 |
85 |
$2.07 |
| 1170F |
|
871 |
789 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
88 |
87 |
$0.00 |
| 1126F |
|
3,766 |
3,361 |
$0.00 |
| 3074F |
|
3,586 |
3,139 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
87 |
38 |
$0.00 |
| 2010F |
|
4,244 |
3,712 |
$0.00 |
| 2001F |
|
3,667 |
3,187 |
$0.00 |
| 1125F |
|
1,129 |
1,044 |
$0.00 |
| 3079F |
|
526 |
503 |
$0.00 |
| 3075F |
|
351 |
337 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
3,673 |
3,544 |
$0.00 |
| 2000F |
|
2,965 |
2,584 |
$0.00 |
| 3008F |
|
4,557 |
3,964 |
$0.00 |
| 3351F |
|
2,704 |
2,375 |
$0.00 |
| 1036F |
|
2,141 |
1,739 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
26 |
25 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
147 |
145 |
$0.00 |
| 94760 |
|
230 |
217 |
$0.00 |
| 3510F |
|
454 |
454 |
$0.00 |
| 90686 |
|
133 |
133 |
$0.00 |
| 82962 |
|
274 |
262 |
$0.00 |
| 3353F |
|
134 |
128 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
54 |
53 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28 |
28 |
$0.00 |
| 0001F |
|
90 |
86 |
$0.00 |
| 1034F |
|
59 |
52 |
$0.00 |
| 90656 |
|
47 |
47 |
$0.00 |
| 1160F |
|
4,253 |
3,377 |
$0.00 |
| 3725F |
|
3,579 |
3,090 |
$0.00 |
| 3078F |
|
3,572 |
3,130 |
$0.00 |
| 18 |
F18 fdg |
950 |
828 |
$0.00 |
| 1159F |
|
5,250 |
4,208 |
$0.00 |
| 99173 |
|
633 |
633 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
214 |
214 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
25 |
25 |
$0.00 |
| 3077F |
|
80 |
76 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
49 |
49 |
$0.00 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
28 |
28 |
$0.00 |
| 1158F |
|
123 |
115 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
15 |
15 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |