| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1000 |
Prenatal care, at-risk assessment |
1,477 |
1,131 |
$169K |
| H2017 |
Psychosocial rehabilitation services, per 15 minutes |
1,953 |
212 |
$97K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,627 |
1,244 |
$31K |
| T1015 |
Clinic visit/encounter, all-inclusive |
566 |
490 |
$29K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,366 |
787 |
$17K |
| H0032 |
Mental health service plan development by non-physician |
234 |
227 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
229 |
207 |
$11K |
| H2000 |
Comprehensive multidisciplinary evaluation |
53 |
49 |
$8K |
| H0031 |
Mental health assessment, by non-physician |
272 |
255 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
84 |
70 |
$4K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
253 |
182 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,093 |
876 |
$3K |
| 90834 |
Psychotherapy, 45 minutes with patient |
41 |
37 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
49 |
49 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
79 |
52 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
351 |
284 |
$1K |
| 2001F |
|
4,380 |
3,088 |
$984.29 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
14 |
$828.60 |
| 90670 |
|
56 |
40 |
$713.18 |
| D1208 |
Topical application of fluoride, excluding varnish |
34 |
34 |
$414.45 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$363.26 |
| 99442 |
|
13 |
12 |
$157.80 |
| 3078F |
|
2,490 |
1,781 |
$141.80 |
| 3074F |
|
2,725 |
1,919 |
$125.00 |
| 1126F |
|
2,382 |
1,830 |
$28.36 |
| 90688 |
|
33 |
32 |
$20.00 |
| 36415 |
Collection of venous blood by venipuncture |
616 |
392 |
$9.00 |
| 3008F |
|
3,631 |
2,615 |
$0.03 |
| 1160F |
|
1,116 |
649 |
$0.00 |
| 90707 |
|
32 |
14 |
$0.00 |
| 1159F |
|
1,117 |
646 |
$0.00 |
| 99401 |
|
378 |
177 |
$0.00 |
| 0502F |
|
349 |
263 |
$0.00 |
| 3077F |
|
21 |
16 |
$0.00 |
| 90715 |
|
49 |
31 |
$0.00 |
| 0124A |
|
27 |
20 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
17 |
17 |
$0.00 |
| 1000F |
|
2,423 |
1,754 |
$0.00 |
| 1125F |
|
244 |
151 |
$0.00 |
| 2000F |
|
2,907 |
2,044 |
$0.00 |
| 1220F |
|
2,362 |
1,573 |
$0.00 |
| 4000F |
|
845 |
666 |
$0.00 |
| 3075F |
|
44 |
39 |
$0.00 |
| 1036F |
|
145 |
97 |
$0.00 |
| 3079F |
|
316 |
209 |
$0.00 |
| 3352F |
|
18 |
17 |
$0.00 |
| 90744 |
|
23 |
12 |
$0.00 |
| D1330 |
|
14 |
14 |
$0.00 |
| 4010F |
|
14 |
12 |
$0.00 |
| 3351F |
|
173 |
146 |
$0.00 |
| 1157F |
|
102 |
50 |
$0.00 |
| 90686 |
|
21 |
15 |
$0.00 |