| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
30,424 |
24,817 |
$2.08M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,359 |
9,815 |
$341K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,433 |
2,755 |
$133K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,961 |
4,675 |
$125K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,272 |
1,993 |
$100K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,009 |
1,742 |
$88K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,498 |
840 |
$49K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,901 |
1,149 |
$49K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,649 |
1,584 |
$33K |
| 90837 |
Psychotherapy, 53 minutes with patient |
714 |
242 |
$29K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,432 |
1,134 |
$12K |
| D1110 |
Prophylaxis - adult |
1,012 |
851 |
$11K |
| 92551 |
|
3,252 |
1,960 |
$8K |
| D0140 |
Limited oral evaluation - problem focused |
822 |
626 |
$7K |
| 90834 |
Psychotherapy, 45 minutes with patient |
261 |
139 |
$6K |
| D0274 |
Bitewings - four radiographic images |
694 |
593 |
$6K |
| 0012A |
|
206 |
206 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
1,136 |
936 |
$4K |
| 0011A |
|
210 |
208 |
$3K |
| 99173 |
|
3,180 |
1,920 |
$3K |
| D1120 |
Prophylaxis - child |
666 |
618 |
$2K |
| 82962 |
|
1,882 |
1,177 |
$2K |
| D1206 |
Topical application of fluoride varnish |
351 |
289 |
$2K |
| 81002 |
|
1,413 |
834 |
$2K |
| 81003 |
|
1,399 |
892 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
706 |
639 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
59 |
41 |
$1K |
| 96127 |
|
530 |
291 |
$1K |
| 0013A |
|
33 |
30 |
$859.60 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
29 |
24 |
$641.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
16 |
13 |
$618.29 |
| 99385 |
|
30 |
12 |
$589.44 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
22 |
12 |
$489.76 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
53 |
30 |
$385.40 |
| 90686 |
|
1,010 |
624 |
$255.10 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
24 |
12 |
$178.03 |
| 81025 |
|
29 |
26 |
$148.20 |
| D0272 |
Bitewings - two radiographic images |
42 |
41 |
$140.00 |
| D0220 |
Intraoral - periapical first radiographic image |
32 |
29 |
$105.00 |
| 90670 |
|
1,088 |
753 |
$79.71 |
| 90698 |
|
604 |
433 |
$79.45 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
38 |
26 |
$79.14 |
| 90710 |
|
365 |
246 |
$31.78 |
| 90633 |
|
492 |
361 |
$16.73 |
| 36415 |
Collection of venous blood by venipuncture |
34 |
19 |
$15.86 |
| 90685 |
|
105 |
67 |
$15.83 |
| 91301 |
|
492 |
484 |
$4.21 |
| 90734 |
|
257 |
170 |
$0.23 |
| 90744 |
|
288 |
206 |
$0.14 |
| 90651 |
|
311 |
210 |
$0.14 |
| 90715 |
|
69 |
55 |
$0.06 |
| 90621 |
|
92 |
68 |
$0.06 |
| 3077F |
|
779 |
483 |
$0.01 |
| 3079F |
|
1,436 |
931 |
$0.01 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
2,658 |
1,806 |
$0.00 |
| 3078F |
|
6,983 |
4,252 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
140 |
94 |
$0.00 |
| 90661 |
|
64 |
62 |
$0.00 |
| 90700 |
|
25 |
15 |
$0.00 |
| 3008F |
|
12,981 |
7,760 |
$0.00 |
| 1036F |
|
5,433 |
3,278 |
$0.00 |
| 3075F |
|
142 |
109 |
$0.00 |
| 3074F |
|
8,095 |
4,929 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
3,365 |
2,749 |
$0.00 |
| 3080F |
|
331 |
191 |
$0.00 |
| 2001F |
|
4,343 |
2,823 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
2,719 |
1,847 |
$0.00 |
| 90619 |
|
12 |
12 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
79 |
53 |
$0.00 |
| 90674 |
|
42 |
28 |
$0.00 |
| 90677 |
|
14 |
13 |
$0.00 |
| 90696 |
|
68 |
40 |
$0.00 |