| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,508 |
1,131 |
$543K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
100 |
100 |
$57K |
| D0140 |
Limited oral evaluation - problem focused |
56 |
55 |
$40K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
38 |
26 |
$26K |
| 81002 |
|
16 |
15 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$9K |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$5K |
| 92015 |
Determination of refractive state |
189 |
168 |
$2K |
| D1206 |
Topical application of fluoride varnish |
21 |
19 |
$653.00 |