| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
5,498 |
4,577 |
$1.92M |
| 3078F |
|
1,028 |
819 |
$620.00 |
| 3074F |
|
1,244 |
998 |
$620.00 |
| 3079F |
|
330 |
278 |
$250.00 |
| 3077F |
|
98 |
79 |
$200.00 |
| 90480 |
|
15 |
14 |
$160.00 |
| 3075F |
|
130 |
111 |
$60.00 |
| 3080F |
|
47 |
41 |
$40.00 |
| 1159F |
|
1,290 |
1,020 |
$0.00 |
| 1160F |
|
1,287 |
1,017 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
93 |
92 |
$0.00 |
| G9920 |
Screening performed and negative |
135 |
121 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
72 |
70 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
13 |
13 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
852 |
737 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
403 |
389 |
$0.00 |
| 3008F |
|
1,924 |
1,582 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
993 |
898 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
33 |
33 |
$0.00 |
| D1330 |
|
32 |
31 |
$0.00 |
| D1310 |
|
15 |
14 |
$0.00 |
| 90686 |
|
27 |
26 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
37 |
33 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
13 |
13 |
$0.00 |