| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
21,736 |
17,050 |
$3.48M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,143 |
7,883 |
$284K |
| D0999 |
Unspecified diagnostic procedure, by report |
2,010 |
1,812 |
$258K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,896 |
3,345 |
$176K |
| 90834 |
Psychotherapy, 45 minutes with patient |
966 |
518 |
$49K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
546 |
537 |
$44K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,470 |
2,836 |
$42K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
507 |
488 |
$39K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
696 |
543 |
$38K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,416 |
1,082 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
155 |
153 |
$15K |
| 99000 |
|
2,753 |
2,539 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
982 |
916 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,431 |
1,338 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
552 |
497 |
$8K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
684 |
611 |
$6K |
| 99215 |
Prolong outpt/office vis |
125 |
102 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
82 |
77 |
$4K |
| 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 |
199 |
168 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
29 |
29 |
$3K |
| 90461 |
|
1,523 |
1,190 |
$3K |
| 99384 |
|
26 |
17 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
90 |
76 |
$836.98 |
| 92551 |
|
1,902 |
1,784 |
$606.82 |
| 87807 |
|
65 |
60 |
$594.00 |
| 81025 |
|
120 |
100 |
$319.06 |
| 90686 |
|
689 |
656 |
$312.48 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
109 |
91 |
$229.04 |
| 90651 |
|
227 |
215 |
$200.00 |
| 90620 |
|
19 |
17 |
$168.05 |
| D0120 |
Periodic oral evaluation - established patient |
731 |
699 |
$115.40 |
| D1120 |
Prophylaxis - child |
529 |
513 |
$73.50 |
| D0210 |
Intraoral - complete series of radiographic images |
122 |
117 |
$70.64 |
| 81002 |
|
35 |
28 |
$70.08 |
| D0220 |
Intraoral - periapical first radiographic image |
678 |
645 |
$64.24 |
| D1206 |
Topical application of fluoride varnish |
580 |
555 |
$44.10 |
| D0274 |
Bitewings - four radiographic images |
332 |
314 |
$34.61 |
| D0230 |
Intraoral - periapical each additional radiographic image |
632 |
600 |
$34.53 |
| 90656 |
|
81 |
79 |
$17.47 |
| D1208 |
Topical application of fluoride, excluding varnish |
254 |
246 |
$14.70 |
| 90785 |
|
238 |
135 |
$0.24 |
| D0603 |
|
385 |
373 |
$0.00 |
| 90696 |
|
33 |
33 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,650 |
1,538 |
$0.00 |
| D0602 |
|
514 |
503 |
$0.00 |
| 90677 |
|
80 |
76 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
44 |
42 |
$0.00 |
| 90680 |
|
13 |
12 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
19 |
13 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
14 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
14 |
14 |
$0.00 |
| 99173 |
|
2,031 |
1,900 |
$0.00 |
| 90715 |
|
58 |
49 |
$0.00 |
| 90685 |
|
28 |
28 |
$0.00 |
| 90633 |
|
79 |
78 |
$0.00 |
| 90670 |
|
115 |
115 |
$0.00 |
| 90734 |
|
145 |
128 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
18 |
15 |
$0.00 |
| D1110 |
Prophylaxis - adult |
139 |
131 |
$0.00 |
| 99080 |
|
13 |
13 |
$0.00 |
| 90710 |
|
32 |
32 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
26 |
15 |
$0.00 |