| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
28,735 |
22,481 |
$4.05M |
| D0999 |
Unspecified diagnostic procedure, by report |
2,737 |
2,217 |
$273K |
| 96127 |
|
11,635 |
9,259 |
$256.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,807 |
8,319 |
$242.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,864 |
5,073 |
$181.50 |
| 36415 |
Collection of venous blood by venipuncture |
8,745 |
4,423 |
$134.00 |
| 81002 |
|
4,045 |
3,142 |
$106.20 |
| 0502F |
|
2,159 |
1,446 |
$85.10 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
730 |
590 |
$73.65 |
| 81025 |
|
2,853 |
2,388 |
$59.58 |
| 97802 |
|
562 |
514 |
$41.00 |
| G0008 |
Administration of influenza virus vaccine |
686 |
609 |
$39.80 |
| 99173 |
|
1,688 |
1,497 |
$39.00 |
| 90686 |
|
564 |
486 |
$33.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
639 |
574 |
$32.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,343 |
1,208 |
$20.00 |
| 90633 |
|
430 |
375 |
$17.00 |
| 90670 |
|
806 |
717 |
$17.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,090 |
1,767 |
$15.00 |
| 92551 |
|
30 |
30 |
$15.00 |
| 90723 |
|
633 |
571 |
$12.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
263 |
243 |
$11.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
600 |
546 |
$7.00 |
| 93000 |
|
166 |
142 |
$6.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
404 |
368 |
$5.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
497 |
472 |
$4.00 |
| 90651 |
|
157 |
136 |
$3.00 |
| 85018 |
|
127 |
101 |
$1.80 |
| 90734 |
|
157 |
144 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
240 |
219 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
324 |
273 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
806 |
766 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
682 |
663 |
$0.00 |
| D1120 |
Prophylaxis - child |
392 |
386 |
$0.00 |
| 90710 |
|
34 |
28 |
$0.00 |
| 82947 |
|
185 |
151 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
153 |
148 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
28 |
27 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
151 |
113 |
$0.00 |
| 3078F |
|
367 |
352 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
27 |
27 |
$0.00 |
| D1110 |
Prophylaxis - adult |
142 |
140 |
$0.00 |
| 90707 |
|
28 |
27 |
$0.00 |
| 81003 |
|
18 |
12 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
91 |
60 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
28 |
25 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
28 |
28 |
$0.00 |
| 90715 |
|
19 |
19 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
29 |
27 |
$0.00 |
| 90700 |
|
14 |
13 |
$0.00 |
| 99381 |
|
66 |
66 |
$0.00 |
| 90680 |
|
295 |
275 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,209 |
1,092 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
136 |
134 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
235 |
234 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
703 |
692 |
$0.00 |
| 90716 |
|
29 |
28 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
25 |
12 |
$0.00 |
| 90647 |
|
234 |
214 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
331 |
318 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
32 |
31 |
$0.00 |
| 90696 |
|
16 |
14 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
46 |
44 |
$0.00 |
| 3074F |
|
405 |
387 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
529 |
514 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
35 |
26 |
$0.00 |
| 90733 |
|
72 |
46 |
$0.00 |
| 1126F |
|
297 |
285 |
$0.00 |
| 90677 |
|
103 |
103 |
$0.00 |
| 90620 |
|
19 |
14 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
65 |
63 |
$0.00 |
| 3079F |
|
26 |
25 |
$0.00 |
| 99383 |
|
14 |
13 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
20 |
15 |
$0.00 |
| D1351 |
Sealant - per tooth |
38 |
15 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| 0500F |
|
14 |
13 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
16 |
16 |
$0.00 |