| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
13,038 |
10,906 |
$6.63M |
| D0999 |
Unspecified diagnostic procedure, by report |
4,027 |
3,566 |
$1.74M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,874 |
3,517 |
$68K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,328 |
2,116 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
30 |
29 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
344 |
315 |
$653.73 |
| 36415 |
Collection of venous blood by venipuncture |
59 |
55 |
$576.24 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
35 |
34 |
$359.05 |
| D0220 |
Intraoral - periapical first radiographic image |
494 |
470 |
$321.48 |
| D1110 |
Prophylaxis - adult |
40 |
40 |
$213.76 |
| 92015 |
Determination of refractive state |
585 |
582 |
$201.87 |
| 80053 |
Comprehensive metabolic panel |
40 |
38 |
$152.35 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
59 |
59 |
$107.79 |
| D0330 |
Panoramic radiographic image |
45 |
42 |
$99.36 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
57 |
57 |
$88.48 |
| D0274 |
Bitewings - four radiographic images |
53 |
50 |
$86.49 |
| 0013A |
|
30 |
30 |
$80.02 |
| D0120 |
Periodic oral evaluation - established patient |
37 |
37 |
$40.48 |
| 0001A |
|
14 |
14 |
$40.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
269 |
91 |
$24.84 |
| D1999 |
|
321 |
311 |
$0.00 |
| 91300 |
|
59 |
46 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
457 |
271 |
$0.00 |
| D0190 |
|
79 |
64 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
70 |
51 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
237 |
174 |
$0.00 |
| 91301 |
|
259 |
252 |
$0.00 |
| D9999 |
Unspecified adjunctive procedure, by report |
339 |
184 |
$0.00 |
| D1330 |
|
219 |
211 |
$0.00 |
| 0011A |
|
76 |
76 |
$0.00 |
| D8670 |
Periodic orthodontic treatment visit |
40 |
40 |
$0.00 |
| D1310 |
|
15 |
12 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
26 |
25 |
$0.00 |
| 0012A |
|
59 |
59 |
$0.00 |
| 91307 |
|
12 |
12 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
15 |
15 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
626 |
603 |
$-3135.13 |