| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
98,802 |
84,062 |
$18.84M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
22,804 |
20,108 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
41,774 |
36,188 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,102 |
1,998 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,642 |
2,367 |
$723.07 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,069 |
1,951 |
$368.27 |
| 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 |
2,301 |
1,994 |
$322.87 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,536 |
1,452 |
$256.71 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
37 |
31 |
$132.91 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
59 |
44 |
$105.66 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
9,174 |
8,608 |
$92.58 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
789 |
758 |
$86.51 |
| 0071A |
|
27 |
25 |
$66.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,286 |
2,123 |
$60.84 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,953 |
1,834 |
$51.31 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,210 |
2,090 |
$43.16 |
| 0011A |
|
102 |
95 |
$40.00 |
| 82044 |
|
975 |
905 |
$37.38 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
807 |
743 |
$30.88 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,153 |
1,958 |
$24.48 |
| 90686 |
|
4,765 |
4,299 |
$23.16 |
| 81002 |
|
4,445 |
3,951 |
$20.32 |
| 81025 |
|
971 |
888 |
$7.92 |
| 0031A |
|
65 |
63 |
$7.76 |
| 99173 |
|
2,599 |
2,513 |
$5.46 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,152 |
1,860 |
$3.88 |
| 90670 |
|
1,500 |
1,411 |
$1.26 |
| 90648 |
|
1,387 |
1,290 |
$1.06 |
| 90723 |
|
957 |
890 |
$0.40 |
| 93000 |
|
116 |
116 |
$0.00 |
| D1330 |
|
2,704 |
2,247 |
$0.00 |
| 90651 |
|
395 |
358 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,566 |
1,483 |
$0.00 |
| 87428 |
|
117 |
111 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
2,057 |
1,713 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
847 |
650 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,292 |
921 |
$0.00 |
| 91303 |
|
58 |
55 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
363 |
320 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
408 |
347 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
2,691 |
2,252 |
$0.00 |
| 82962 |
|
134 |
127 |
$0.00 |
| 85018 |
|
42 |
40 |
$0.00 |
| 36416 |
|
49 |
42 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
125 |
85 |
$0.00 |
| D1351 |
Sealant - per tooth |
206 |
53 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
669 |
303 |
$0.00 |
| D0603 |
|
665 |
650 |
$0.00 |
| 91306 |
|
49 |
46 |
$0.00 |
| 0064A |
|
67 |
65 |
$0.00 |
| 91307 |
|
76 |
74 |
$0.00 |
| D0601 |
|
13 |
13 |
$0.00 |
| 90677 |
|
12 |
12 |
$0.00 |
| 90716 |
|
45 |
40 |
$0.00 |
| 90480 |
|
84 |
78 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
104 |
103 |
$0.00 |
| 0012A |
|
60 |
60 |
$0.00 |
| D0602 |
|
71 |
70 |
$0.00 |
| 99381 |
|
42 |
38 |
$0.00 |
| 90696 |
|
26 |
26 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
137 |
124 |
$0.00 |
| 0134A |
|
23 |
20 |
$0.00 |
| 0072A |
|
17 |
16 |
$0.00 |
| 91301 |
|
157 |
145 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16 |
14 |
$0.00 |
| D1120 |
Prophylaxis - child |
1,896 |
1,564 |
$0.00 |
| 90461 |
|
3,980 |
3,780 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
1,582 |
1,287 |
$0.00 |
| 90633 |
|
483 |
435 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
970 |
951 |
$0.00 |
| 90715 |
|
374 |
360 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
511 |
491 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
595 |
468 |
$0.00 |
| D1110 |
Prophylaxis - adult |
299 |
233 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,557 |
1,514 |
$0.00 |
| 90681 |
|
383 |
357 |
$0.00 |
| 90734 |
|
235 |
206 |
$0.00 |
| 90662 |
|
261 |
235 |
$0.00 |
| 90685 |
|
201 |
162 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
28 |
27 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
109 |
91 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
559 |
260 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
222 |
186 |
$0.00 |
| D1999 |
|
338 |
271 |
$0.00 |
| 91300 |
|
53 |
49 |
$0.00 |
| 90710 |
|
16 |
16 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
26 |
26 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
74 |
70 |
$0.00 |
| D0330 |
Panoramic radiographic image |
74 |
49 |
$0.00 |
| 90700 |
|
13 |
12 |
$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 |
154 |
140 |
$0.00 |
| 2028F |
|
57 |
55 |
$0.00 |
| 99442 |
|
26 |
25 |
$0.00 |
| 90707 |
|
31 |
26 |
$0.00 |
| 0004A |
|
16 |
15 |
$0.00 |
| 91320 |
|
26 |
20 |
$0.00 |
| 91313 |
|
12 |
12 |
$0.00 |
| 0124A |
|
16 |
16 |
$0.00 |
| 90621 |
|
12 |
12 |
$0.00 |