| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,823 |
4,039 |
$1.54M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,416 |
1,221 |
$43K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
485 |
427 |
$18K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
421 |
370 |
$9K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
125 |
94 |
$5K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
42 |
42 |
$4K |
| 0012A |
|
81 |
81 |
$3K |
| 0011A |
|
100 |
92 |
$2K |
| 0002A |
|
39 |
38 |
$1K |
| 0001A |
|
38 |
36 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
87 |
84 |
$919.47 |
| 90686 |
|
90 |
84 |
$907.18 |
| 99215 |
Prolong outpt/office vis |
14 |
13 |
$889.07 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
150 |
138 |
$773.73 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
35 |
33 |
$767.20 |
| 80053 |
Comprehensive metabolic panel |
61 |
55 |
$516.75 |
| 0064A |
|
12 |
12 |
$440.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
69 |
68 |
$408.31 |
| 36415 |
Collection of venous blood by venipuncture |
187 |
175 |
$306.32 |
| D1206 |
Topical application of fluoride varnish |
17 |
17 |
$296.37 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
40 |
38 |
$290.14 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
65 |
58 |
$273.95 |
| 84443 |
Thyroid stimulating hormone (TSH) |
14 |
14 |
$228.67 |
| 90688 |
|
16 |
14 |
$209.23 |
| D0140 |
Limited oral evaluation - problem focused |
12 |
12 |
$185.39 |
| 83718 |
|
15 |
15 |
$102.84 |
| 81002 |
|
31 |
28 |
$65.44 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$64.40 |
| 82465 |
|
15 |
15 |
$53.00 |
| 99000 |
|
196 |
156 |
$0.00 |
| 91301 |
|
26 |
18 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
15 |
15 |
$0.00 |
| 83721 |
|
15 |
15 |
$0.00 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
20 |
17 |
$0.00 |