| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
264,796 |
189,508 |
$27.10M |
| D9430 |
|
34,312 |
22,298 |
$3.30M |
| 90651 |
|
362 |
338 |
$81K |
| 90686 |
|
2,862 |
2,763 |
$36K |
| 90649 |
|
1,684 |
1,589 |
$28K |
| 90670 |
|
2,593 |
2,496 |
$19K |
| 90734 |
|
1,138 |
1,037 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
97,045 |
72,628 |
$13K |
| 90710 |
|
1,124 |
1,083 |
$13K |
| 90633 |
|
1,721 |
1,637 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,360 |
2,772 |
$11K |
| 90700 |
|
1,214 |
1,178 |
$9K |
| 90648 |
|
1,329 |
1,275 |
$9K |
| 90698 |
|
1,455 |
1,084 |
$8K |
| 90715 |
|
711 |
678 |
$7K |
| 90680 |
|
821 |
795 |
$6K |
| 90723 |
|
886 |
857 |
$6K |
| 90744 |
|
598 |
583 |
$5K |
| 90620 |
|
495 |
348 |
$4K |
| 90716 |
|
373 |
355 |
$4K |
| 90674 |
|
211 |
196 |
$3K |
| 90707 |
|
351 |
330 |
$3K |
| 90688 |
|
180 |
173 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27,962 |
19,013 |
$2K |
| 90685 |
|
428 |
336 |
$2K |
| 90681 |
|
278 |
259 |
$1K |
| D1120 |
Prophylaxis - child |
11,628 |
8,874 |
$1K |
| 92551 |
|
14,814 |
13,320 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
582 |
510 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
10,295 |
8,020 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
13,965 |
10,491 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
16,815 |
12,354 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14,037 |
10,992 |
$816.47 |
| D0330 |
Panoramic radiographic image |
4,387 |
3,161 |
$808.00 |
| 90713 |
|
84 |
79 |
$759.82 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
11,042 |
7,237 |
$678.30 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12,466 |
9,618 |
$651.36 |
| D1110 |
Prophylaxis - adult |
2,352 |
1,626 |
$561.00 |
| 81025 |
|
60,700 |
40,442 |
$539.95 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
977 |
556 |
$497.00 |
| 90656 |
|
85 |
85 |
$481.00 |
| 90696 |
|
58 |
50 |
$442.70 |
| 90697 |
|
483 |
397 |
$439.77 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,739 |
5,373 |
$433.68 |
| D0272 |
Bitewings - two radiographic images |
6,860 |
5,299 |
$381.50 |
| D0140 |
Limited oral evaluation - problem focused |
3,510 |
2,734 |
$330.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
8,196 |
6,947 |
$316.36 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12,327 |
10,129 |
$257.24 |
| 90660 |
|
32 |
32 |
$248.00 |
| D0274 |
Bitewings - four radiographic images |
1,258 |
819 |
$231.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
623 |
353 |
$199.00 |
| 99173 |
|
17,029 |
15,242 |
$198.37 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,048 |
2,683 |
$116.94 |
| 99347 |
|
1,459 |
1,370 |
$115.74 |
| 36415 |
Collection of venous blood by venipuncture |
36,706 |
24,485 |
$111.66 |
| 81003 |
|
20,636 |
13,983 |
$97.46 |
| 85018 |
|
9,570 |
8,140 |
$69.88 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,654 |
2,489 |
$55.65 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,772 |
3,118 |
$43.45 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,532 |
986 |
$40.00 |
| 87210 |
|
2,312 |
1,549 |
$23.52 |
| D0220 |
Intraoral - periapical first radiographic image |
222 |
136 |
$17.00 |
| 82570 |
|
598 |
468 |
$4.64 |
| 88142 |
|
308 |
230 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
6,469 |
5,593 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
620 |
415 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
248 |
214 |
$0.00 |
| 90619 |
|
749 |
596 |
$0.00 |
| 87807 |
|
710 |
624 |
$0.00 |
| 36416 |
|
1,025 |
911 |
$0.00 |
| 87081 |
|
430 |
385 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
173 |
149 |
$0.00 |
| J0456 |
Injection, azithromycin, 500 mg |
69 |
53 |
$0.00 |
| D1330 |
|
78 |
59 |
$0.00 |
| 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 |
358 |
318 |
$0.00 |
| 85660 |
|
46 |
39 |
$0.00 |
| 87340 |
|
44 |
37 |
$0.00 |
| 99383 |
|
337 |
230 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
562 |
403 |
$0.00 |
| 99381 |
|
152 |
145 |
$0.00 |
| 86762 |
|
26 |
24 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
108 |
75 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
57 |
45 |
$0.00 |
| A9150 |
Non-prescription drugs |
43 |
38 |
$0.00 |
| 99384 |
|
88 |
45 |
$0.00 |
| 90694 |
|
30 |
15 |
$0.00 |
| 86850 |
|
46 |
39 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
153 |
91 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
87 |
77 |
$0.00 |
| 0072A |
|
27 |
27 |
$0.00 |
| 90657 |
|
14 |
14 |
$0.00 |
| D9999 |
Unspecified adjunctive procedure, by report |
50 |
40 |
$0.00 |
| 86901 |
|
46 |
39 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
25 |
24 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
35 |
24 |
$0.00 |
| 97802 |
|
31 |
29 |
$0.00 |
| 87320 |
|
13 |
13 |
$0.00 |
| D1351 |
Sealant - per tooth |
84 |
15 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
43 |
42 |
$0.00 |
| 0031A |
|
30 |
29 |
$0.00 |
| 86580 |
|
33 |
28 |
$0.00 |
| 86308 |
|
15 |
14 |
$0.00 |
| 0012A |
|
12 |
12 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
7,396 |
6,163 |
$0.00 |
| 84439 |
|
132 |
102 |
$0.00 |
| 83718 |
|
2,624 |
1,856 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
354 |
254 |
$0.00 |
| 92015 |
Determination of refractive state |
1,600 |
1,358 |
$0.00 |
| 0071A |
|
39 |
36 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
971 |
871 |
$0.00 |
| 90671 |
|
820 |
651 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,095 |
1,023 |
$0.00 |
| 82947 |
|
123 |
104 |
$0.00 |
| 86900 |
|
46 |
39 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
611 |
372 |
$0.00 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
85 |
68 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
235 |
101 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
164 |
106 |
$0.00 |
| 99201 |
|
77 |
75 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
66 |
50 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
14 |
12 |
$0.00 |
| 90661 |
|
139 |
97 |
$0.00 |
| 82274 |
|
24 |
16 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
301 |
254 |
$0.00 |
| 99382 |
|
73 |
42 |
$0.00 |
| 80061 |
Lipid panel |
403 |
283 |
$0.00 |
| 82948 |
|
94 |
79 |
$0.00 |
| 83655 |
|
109 |
69 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
45 |
27 |
$0.00 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
14 |
13 |
$0.00 |
| Z5183 |
|
12 |
12 |
$0.00 |
| 86631 |
|
122 |
94 |
$0.00 |
| 90653 |
|
13 |
12 |
$0.00 |
| 90473 |
|
12 |
12 |
$0.00 |
| 97803 |
|
23 |
22 |
$0.00 |
| 80305 |
|
28 |
14 |
$0.00 |
| 90658 |
|
16 |
16 |
$0.00 |