| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
10,157 |
4,854 |
$1.14M |
| H2020 |
Therapeutic behavioral services, per diem |
3,371 |
1,468 |
$362K |
| D0999 |
Unspecified diagnostic procedure, by report |
1,372 |
1,004 |
$117K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
204 |
105 |
$886.54 |
| D0210 |
Intraoral - complete series of radiographic images |
30 |
13 |
$59.27 |
| 3078F |
|
200 |
119 |
$5.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,432 |
1,078 |
$0.00 |
| 3074F |
|
218 |
133 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
526 |
512 |
$0.00 |
| 1036F |
|
1,108 |
581 |
$0.00 |
| 2001F |
|
700 |
493 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
722 |
664 |
$0.00 |
| 1111F |
|
133 |
91 |
$0.00 |
| 92551 |
|
83 |
72 |
$0.00 |
| 3079F |
|
17 |
17 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
347 |
213 |
$0.00 |
| 1125F |
|
40 |
33 |
$0.00 |
| 90686 |
|
147 |
128 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
159 |
112 |
$0.00 |
| 3008F |
|
662 |
464 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
207 |
165 |
$0.00 |
| 1126F |
|
122 |
95 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
894 |
716 |
$0.00 |
| 85018 |
|
93 |
59 |
$0.00 |
| 96127 |
|
53 |
27 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
258 |
181 |
$0.00 |
| 1034F |
|
19 |
15 |
$0.00 |
| 1035F |
|
19 |
15 |
$0.00 |
| 99174 |
|
51 |
50 |
$0.00 |
| 87428 |
|
14 |
14 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
43 |
27 |
$0.00 |
| D0602 |
|
25 |
24 |
$0.00 |
| 36416 |
|
14 |
13 |
$0.00 |
| 99173 |
|
103 |
87 |
$0.00 |
| 99177 |
|
96 |
81 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
12 |
12 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
499 |
337 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,317 |
1,403 |
$0.00 |
| D1110 |
Prophylaxis - adult |
429 |
386 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
2,929 |
1,380 |
$0.00 |
| D1120 |
Prophylaxis - child |
15 |
15 |
$0.00 |
| 96160 |
|
237 |
169 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
201 |
145 |
$0.00 |
| 81003 |
|
156 |
110 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
193 |
142 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
185 |
152 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
66 |
53 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
357 |
86 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
100 |
49 |
$0.00 |
| 1159F |
|
151 |
110 |
$0.00 |
| D1203 |
|
37 |
20 |
$0.00 |
| 82947 |
|
110 |
67 |
$0.00 |