| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
11,945 |
5,107 |
$1.31M |
| H2020 |
Therapeutic behavioral services, per diem |
4,368 |
1,839 |
$484K |
| D0999 |
Unspecified diagnostic procedure, by report |
965 |
692 |
$85K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
374 |
178 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
169 |
146 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,000 |
2,118 |
$0.00 |
| 3008F |
|
1,108 |
758 |
$0.00 |
| 1036F |
|
391 |
249 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
434 |
429 |
$0.00 |
| 92551 |
|
99 |
77 |
$0.00 |
| 1111F |
|
270 |
195 |
$0.00 |
| 2001F |
|
1,127 |
765 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
463 |
361 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
343 |
224 |
$0.00 |
| D1351 |
Sealant - per tooth |
89 |
28 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
530 |
457 |
$0.00 |
| 1126F |
|
183 |
158 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
16 |
15 |
$0.00 |
| 3074F |
|
398 |
255 |
$0.00 |
| 85018 |
|
47 |
25 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
277 |
194 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
90 |
78 |
$0.00 |
| 1125F |
|
134 |
111 |
$0.00 |
| D0602 |
|
43 |
41 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
33 |
32 |
$0.00 |
| 99174 |
|
115 |
112 |
$0.00 |
| 99172 |
|
20 |
20 |
$0.00 |
| 90686 |
|
103 |
95 |
$0.00 |
| D0603 |
|
32 |
30 |
$0.00 |
| 81003 |
|
132 |
90 |
$0.00 |
| 99177 |
|
239 |
205 |
$0.00 |
| D1120 |
Prophylaxis - child |
660 |
613 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,233 |
1,051 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,968 |
1,196 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
826 |
503 |
$0.00 |
| 90672 |
|
107 |
91 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
96 |
86 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
3,344 |
1,597 |
$0.00 |
| 3078F |
|
362 |
228 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
271 |
200 |
$0.00 |
| 82947 |
|
46 |
24 |
$0.00 |
| 96160 |
|
276 |
194 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
383 |
271 |
$0.00 |
| 90473 |
|
50 |
50 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
549 |
129 |
$0.00 |
| 1159F |
|
270 |
193 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
25 |
$0.00 |
| D1203 |
|
40 |
29 |
$0.00 |