| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
32,365 |
20,882 |
$5.85M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
154,335 |
142,108 |
$2.75M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
23,437 |
23,148 |
$528K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
9,159 |
9,112 |
$460K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
7,923 |
7,841 |
$351K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
5,851 |
5,777 |
$311K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
7,818 |
7,644 |
$280K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,554 |
6,982 |
$172K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15,099 |
14,783 |
$163K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
3,168 |
3,131 |
$136K |
| 90461 |
|
8,461 |
8,401 |
$134K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
292 |
292 |
$128K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,904 |
2,830 |
$122K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,954 |
2,933 |
$107K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,495 |
5,178 |
$103K |
| 97803 |
|
3,010 |
2,725 |
$87K |
| D0120 |
Periodic oral evaluation - established patient |
3,913 |
3,704 |
$79K |
| 97802 |
|
1,725 |
1,681 |
$70K |
| 90619 |
|
631 |
614 |
$66K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
5,009 |
4,889 |
$59K |
| 90677 |
|
456 |
443 |
$57K |
| 90686 |
|
9,115 |
8,843 |
$52K |
| 98940 |
|
5,946 |
2,901 |
$44K |
| D0210 |
Intraoral - complete series of radiographic images |
1,894 |
1,830 |
$39K |
| 99429 |
|
3,749 |
3,645 |
$37K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,810 |
1,806 |
$32K |
| 90649 |
|
533 |
525 |
$32K |
| D1110 |
Prophylaxis - adult |
2,464 |
2,395 |
$31K |
| 0011A |
|
966 |
966 |
$29K |
| 90651 |
|
699 |
680 |
$28K |
| 3008F |
|
3,307 |
3,219 |
$27K |
| D1120 |
Prophylaxis - child |
2,188 |
2,129 |
$23K |
| D1206 |
Topical application of fluoride varnish |
2,096 |
2,038 |
$23K |
| D0140 |
Limited oral evaluation - problem focused |
1,993 |
1,965 |
$21K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
557 |
554 |
$21K |
| 0012A |
|
526 |
526 |
$20K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
336 |
302 |
$18K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
1,952 |
911 |
$18K |
| 0002A |
|
393 |
391 |
$15K |
| 0001A |
|
390 |
390 |
$15K |
| 90670 |
|
2,157 |
2,068 |
$12K |
| 90734 |
|
511 |
505 |
$10K |
| 0071A |
|
226 |
226 |
$9K |
| 90715 |
|
708 |
689 |
$9K |
| 96127 |
|
6,307 |
5,653 |
$9K |
| 59514 |
|
18 |
16 |
$9K |
| 99188 |
|
516 |
502 |
$8K |
| D0220 |
Intraoral - periapical first radiographic image |
3,288 |
3,197 |
$8K |
| 90688 |
|
590 |
590 |
$8K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
234 |
161 |
$7K |
| 0072A |
|
166 |
166 |
$7K |
| 90671 |
|
42 |
42 |
$6K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
166 |
125 |
$6K |
| 90620 |
|
214 |
203 |
$6K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
442 |
218 |
$6K |
| 90710 |
|
521 |
505 |
$6K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
200 |
158 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,810 |
1,660 |
$4K |
| 86580 |
|
1,075 |
1,065 |
$4K |
| D0274 |
Bitewings - four radiographic images |
1,078 |
1,044 |
$4K |
| 99386 |
|
130 |
123 |
$4K |
| 99385 |
|
89 |
86 |
$4K |
| 96160 |
|
3,123 |
2,867 |
$4K |
| 90656 |
|
839 |
823 |
$4K |
| 99442 |
|
212 |
194 |
$3K |
| 99381 |
|
773 |
771 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
469 |
439 |
$3K |
| 90723 |
|
577 |
566 |
$3K |
| 90698 |
|
1,375 |
1,307 |
$3K |
| 90633 |
|
1,306 |
1,258 |
$2K |
| 0064A |
|
61 |
61 |
$2K |
| 11721 |
|
124 |
124 |
$2K |
| 90658 |
|
334 |
334 |
$2K |
| 0134A |
|
48 |
46 |
$2K |
| 90681 |
|
804 |
777 |
$2K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
324 |
184 |
$1K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
465 |
236 |
$1K |
| 99383 |
|
25 |
25 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
124 |
124 |
$1K |
| D0601 |
|
177 |
164 |
$950.00 |
| 90716 |
|
73 |
68 |
$934.90 |
| 82962 |
|
2,735 |
2,457 |
$878.15 |
| 90744 |
|
852 |
811 |
$868.78 |
| 57454 |
|
14 |
14 |
$861.79 |
| D0603 |
|
99 |
99 |
$740.00 |
| 0031A |
|
18 |
18 |
$720.00 |
| D0272 |
Bitewings - two radiographic images |
125 |
125 |
$615.00 |
| 0013A |
|
15 |
15 |
$600.00 |
| 99441 |
|
81 |
78 |
$521.11 |
| 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 |
4,158 |
3,691 |
$484.34 |
| D0602 |
|
66 |
66 |
$480.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
14 |
14 |
$377.80 |
| 59025 |
Fetal non-stress test |
14 |
13 |
$332.76 |
| D0270 |
|
119 |
119 |
$324.00 |
| 90648 |
|
928 |
882 |
$313.02 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
16 |
14 |
$294.00 |
| 81025 |
|
481 |
465 |
$225.00 |
| 99173 |
|
109 |
109 |
$212.13 |
| 69210 |
|
12 |
12 |
$197.00 |
| D0330 |
Panoramic radiographic image |
15 |
15 |
$173.25 |
| 90707 |
|
13 |
12 |
$169.81 |
| 90696 |
|
54 |
54 |
$163.20 |
| 90700 |
|
89 |
85 |
$133.89 |
| 81002 |
|
309 |
298 |
$133.47 |
| 96150 |
|
47 |
47 |
$97.80 |
| 3077F |
|
4,761 |
4,484 |
$63.00 |
| 90713 |
|
30 |
29 |
$41.87 |
| 3074F |
|
4,140 |
3,889 |
$39.02 |
| 3078F |
|
5,793 |
5,388 |
$36.03 |
| 3079F |
|
3,373 |
3,228 |
$29.01 |
| 3075F |
|
1,960 |
1,856 |
$14.00 |
| 3080F |
|
2,089 |
1,997 |
$10.00 |
| 99000 |
|
80 |
80 |
$4.50 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,102 |
657 |
$2.05 |
| 90791 |
Psychiatric diagnostic evaluation |
1,349 |
1,337 |
$1.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,557 |
1,302 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
708 |
679 |
$0.00 |
| 1159F |
|
44 |
26 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
185 |
175 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
17 |
17 |
$0.00 |
| 1160F |
|
44 |
26 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
12 |
12 |
$0.00 |
| 90655 |
|
15 |
15 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
30 |
30 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
378 |
378 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
17,202 |
9,758 |
$0.00 |
| 1111F |
|
377 |
365 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
197 |
187 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
39 |
39 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
54 |
54 |
$0.00 |
| 88142 |
|
40 |
40 |
$0.00 |
| 1126F |
|
78 |
52 |
$0.00 |
| D9997 |
|
44 |
12 |
$0.00 |
| 99384 |
|
13 |
13 |
$0.00 |