| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
76,260 |
62,801 |
$9.64M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
42,201 |
36,062 |
$1.49M |
| D0999 |
Unspecified diagnostic procedure, by report |
1,932 |
1,693 |
$308K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,256 |
5,782 |
$228K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,221 |
2,117 |
$140K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,289 |
2,119 |
$137K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
3,202 |
2,962 |
$106K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,961 |
1,366 |
$100K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,555 |
1,454 |
$92K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,569 |
3,296 |
$72K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,482 |
5,942 |
$50K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,766 |
1,572 |
$46K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
870 |
826 |
$43K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,656 |
4,179 |
$36K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
557 |
511 |
$32K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
658 |
592 |
$24K |
| 99215 |
Prolong outpt/office vis |
325 |
294 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,878 |
4,452 |
$12K |
| 0001A |
|
423 |
387 |
$11K |
| 0071A |
|
469 |
423 |
$10K |
| 0002A |
|
348 |
327 |
$8K |
| CP002 |
|
754 |
667 |
$7K |
| 0072A |
|
412 |
359 |
$7K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
27 |
14 |
$6K |
| 90621 |
|
61 |
55 |
$6K |
| 90791 |
Psychiatric diagnostic evaluation |
60 |
58 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
56 |
53 |
$3K |
| 99382 |
|
69 |
57 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$3K |
| 99383 |
|
27 |
26 |
$2K |
| 0012A |
|
91 |
86 |
$2K |
| D1110 |
Prophylaxis - adult |
301 |
283 |
$1K |
| 0004A |
|
55 |
48 |
$1K |
| 90461 |
|
1,916 |
1,748 |
$1K |
| 90686 |
|
1,562 |
1,439 |
$1K |
| 99381 |
|
32 |
29 |
$1K |
| 99205 |
Prolong outpt/office vis |
37 |
33 |
$906.57 |
| 92551 |
|
1,033 |
975 |
$874.75 |
| 0031A |
|
54 |
47 |
$789.75 |
| 0054A |
|
31 |
25 |
$760.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
739 |
267 |
$745.19 |
| D0274 |
Bitewings - four radiographic images |
218 |
202 |
$725.76 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
38 |
37 |
$652.00 |
| 0111A |
|
18 |
17 |
$598.00 |
| 0064A |
|
25 |
24 |
$558.00 |
| 0011A |
|
104 |
91 |
$466.67 |
| D0120 |
Periodic oral evaluation - established patient |
427 |
400 |
$414.00 |
| 0124A |
|
40 |
38 |
$360.00 |
| D0220 |
Intraoral - periapical first radiographic image |
311 |
282 |
$359.86 |
| 0074A |
|
16 |
14 |
$320.00 |
| 0134A |
|
17 |
12 |
$320.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
15 |
12 |
$298.35 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,718 |
1,656 |
$263.95 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
43 |
43 |
$249.66 |
| 81003 |
|
63 |
56 |
$239.68 |
| 81025 |
|
56 |
52 |
$175.92 |
| 90734 |
|
275 |
256 |
$159.34 |
| D1206 |
Topical application of fluoride varnish |
602 |
588 |
$155.40 |
| 90710 |
|
82 |
74 |
$141.41 |
| 90697 |
|
12 |
12 |
$135.87 |
| 90656 |
|
334 |
334 |
$69.88 |
| 92558 |
|
14 |
13 |
$68.85 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
25 |
25 |
$40.70 |
| 86580 |
|
81 |
80 |
$31.72 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
607 |
578 |
$20.76 |
| 91301 |
|
250 |
219 |
$0.13 |
| 91300 |
|
825 |
739 |
$0.04 |
| 99173 |
|
2,549 |
2,391 |
$0.00 |
| 92552 |
|
16 |
16 |
$0.00 |
| D1120 |
Prophylaxis - child |
51 |
50 |
$0.00 |
| 90633 |
|
129 |
117 |
$0.00 |
| 90715 |
|
16 |
14 |
$0.00 |
| 90671 |
|
160 |
141 |
$0.00 |
| 90670 |
|
70 |
63 |
$0.00 |
| 90685 |
|
13 |
12 |
$0.00 |
| 91307 |
|
881 |
782 |
$0.00 |
| 3008F |
|
3,868 |
3,681 |
$0.00 |
| D0602 |
|
400 |
382 |
$0.00 |
| 91303 |
|
50 |
45 |
$0.00 |
| 90680 |
|
140 |
137 |
$0.00 |
| 90651 |
|
178 |
169 |
$0.00 |
| 90694 |
|
29 |
29 |
$0.00 |
| 90647 |
|
52 |
45 |
$0.00 |
| 97169 |
|
17 |
17 |
$0.00 |
| 90677 |
|
78 |
78 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
84 |
84 |
$0.00 |
| D0603 |
|
16 |
13 |
$0.00 |