| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
43,138 |
40,526 |
$5.52M |
| 00003 |
Internal/system code - not a standard HCPCS code |
13,207 |
11,749 |
$2.23M |
| G9012 |
Other specified case management service not elsewhere classified |
1,522 |
1,060 |
$79K |
| 0002A |
|
1,762 |
1,493 |
$70K |
| 0001A |
|
1,644 |
1,440 |
$57K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,422 |
10,911 |
$32K |
| 90791 |
Psychiatric diagnostic evaluation |
677 |
423 |
$27K |
| 90834 |
Psychotherapy, 45 minutes with patient |
426 |
248 |
$10K |
| 90832 |
Psychotherapy, 30 minutes with patient |
230 |
136 |
$4K |
| 0004A |
|
76 |
76 |
$3K |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
140 |
80 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
518 |
507 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,276 |
1,252 |
$2K |
| 92551 |
|
203 |
203 |
$2K |
| 0003A |
|
41 |
41 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
22 |
16 |
$2K |
| 0064A |
|
37 |
37 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
517 |
508 |
$861.30 |
| D0120 |
Periodic oral evaluation - established patient |
159 |
106 |
$604.00 |
| D1310 |
|
1,099 |
474 |
$414.00 |
| 85018 |
|
2,396 |
2,364 |
$410.30 |
| 92552 |
|
1,723 |
1,698 |
$322.71 |
| D1110 |
Prophylaxis - adult |
29 |
27 |
$273.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
114 |
112 |
$236.95 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,895 |
1,839 |
$213.90 |
| D0220 |
Intraoral - periapical first radiographic image |
533 |
319 |
$185.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
207 |
204 |
$175.05 |
| 81001 |
|
464 |
425 |
$87.68 |
| D0230 |
Intraoral - periapical each additional radiographic image |
542 |
169 |
$87.30 |
| 99173 |
|
1,848 |
1,823 |
$86.36 |
| 83655 |
|
201 |
196 |
$82.35 |
| 81025 |
|
41 |
41 |
$75.60 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
675 |
662 |
$71.51 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
685 |
669 |
$71.51 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
120 |
119 |
$57.20 |
| 90715 |
|
157 |
155 |
$43.50 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
34 |
16 |
$43.00 |
| D9993 |
|
741 |
696 |
$35.00 |
| 99201 |
|
27 |
26 |
$22.90 |
| 99000 |
|
2,342 |
2,268 |
$22.50 |
| D0603 |
|
728 |
486 |
$16.00 |
| D0210 |
Intraoral - complete series of radiographic images |
32 |
15 |
$9.00 |
| 80053 |
Comprehensive metabolic panel |
2,943 |
2,916 |
$8.44 |
| G9920 |
Screening performed and negative |
184 |
165 |
$0.02 |
| 3074F |
|
3,629 |
3,524 |
$0.00 |
| D1330 |
|
1,650 |
1,096 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
911 |
905 |
$0.00 |
| 82270 |
|
254 |
251 |
$0.00 |
| 90620 |
|
31 |
31 |
$0.00 |
| 90651 |
|
253 |
253 |
$0.00 |
| 3008F |
|
562 |
536 |
$0.00 |
| 99384 |
|
33 |
33 |
$0.00 |
| Z1034 |
|
129 |
100 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
58 |
55 |
$0.00 |
| 99441 |
|
345 |
342 |
$0.00 |
| 3075F |
|
107 |
104 |
$0.00 |
| 90686 |
|
643 |
638 |
$0.00 |
| 90688 |
|
218 |
218 |
$0.00 |
| 99383 |
|
45 |
44 |
$0.00 |
| INPOS |
|
14 |
12 |
$0.00 |
| 91303 |
|
15 |
13 |
$0.00 |
| 90674 |
|
66 |
66 |
$0.00 |
| Z6410 |
|
73 |
63 |
$0.00 |
| 90696 |
|
14 |
14 |
$0.00 |
| 3078F |
|
4,612 |
4,474 |
$0.00 |
| 80061 |
Lipid panel |
1,300 |
1,294 |
$0.00 |
| 90734 |
|
234 |
234 |
$0.00 |
| 82947 |
|
285 |
275 |
$0.00 |
| 99442 |
|
1,289 |
1,241 |
$0.00 |
| 90746 |
|
81 |
81 |
$0.00 |
| 3077F |
|
127 |
127 |
$0.00 |
| 99188 |
|
132 |
131 |
$0.00 |
| 0502F |
|
127 |
98 |
$0.00 |
| 90633 |
|
86 |
83 |
$0.00 |
| 91300 |
|
213 |
206 |
$0.00 |
| 90670 |
|
27 |
27 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
53 |
53 |
$0.00 |
| 90710 |
|
87 |
87 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
21 |
21 |
$0.00 |
| 85049 |
|
28 |
28 |
$0.00 |
| 90648 |
|
24 |
24 |
$0.00 |
| 90713 |
|
12 |
12 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
21 |
14 |
$0.00 |