| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
10,177 |
8,858 |
$2.52M |
| G9012 |
Other specified case management service not elsewhere classified |
890 |
862 |
$217K |
| 3074F |
|
1,564 |
1,464 |
$1K |
| 3078F |
|
1,351 |
1,264 |
$1K |
| 3079F |
|
262 |
249 |
$475.00 |
| 3075F |
|
76 |
75 |
$180.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,726 |
2,423 |
$175.00 |
| 3044F |
|
22 |
22 |
$120.00 |
| 3077F |
|
27 |
25 |
$60.00 |
| 3080F |
|
20 |
20 |
$40.00 |
| 3725F |
|
430 |
417 |
$20.00 |
| 80305 |
|
584 |
513 |
$11.97 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
84 |
81 |
$11.50 |
| 96127 |
|
557 |
528 |
$5.23 |
| 96160 |
|
496 |
474 |
$3.48 |
| 1160F |
|
2,897 |
2,662 |
$0.00 |
| 1159F |
|
2,835 |
2,606 |
$0.00 |
| 81025 |
|
13 |
13 |
$0.00 |
| 99173 |
|
24 |
24 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
179 |
168 |
$0.00 |
| D1110 |
Prophylaxis - adult |
40 |
40 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
42 |
42 |
$0.00 |
| 3008F |
|
2,747 |
2,537 |
$0.00 |
| D0602 |
|
12 |
12 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
855 |
811 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
119 |
111 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
214 |
210 |
$0.00 |
| 92551 |
|
12 |
12 |
$0.00 |
| D1330 |
|
117 |
109 |
$0.00 |
| 90686 |
|
25 |
25 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
67 |
67 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
20 |
20 |
$0.00 |