| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
7,466 |
5,164 |
$2.13M |
| D1206 |
Topical application of fluoride varnish |
14 |
14 |
$0.00 |
| 3008F |
|
210 |
147 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
451 |
431 |
$0.00 |
| 2001F |
|
137 |
80 |
$0.00 |
| 3074F |
|
161 |
118 |
$0.00 |
| 92551 |
|
53 |
53 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24 |
24 |
$0.00 |
| 1036F |
|
143 |
108 |
$0.00 |
| 90461 |
|
39 |
39 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
91 |
89 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$0.00 |
| 99173 |
|
56 |
56 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$0.00 |
| 1159F |
|
186 |
114 |
$0.00 |
| 1160F |
|
15 |
15 |
$0.00 |
| 3078F |
|
15 |
15 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$0.00 |