| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
100,984 |
82,933 |
$9.61M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
113,987 |
65,167 |
$2.43M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
45,156 |
10,832 |
$354K |
| 90832 |
Psychotherapy, 30 minutes with patient |
7,194 |
4,036 |
$145K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,461 |
2,016 |
$114K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,065 |
3,874 |
$96K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,561 |
1,665 |
$64K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,902 |
1,195 |
$49K |
| 90686 |
|
6,819 |
3,852 |
$36K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,336 |
1,985 |
$29K |
| 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 |
2,019 |
1,001 |
$26K |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
1,760 |
1,206 |
$25K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
649 |
428 |
$15K |
| T2003 |
Non-emergency transportation; encounter/trip |
1,109 |
566 |
$11K |
| 0051A |
|
298 |
297 |
$10K |
| 0064A |
|
253 |
245 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
645 |
487 |
$8K |
| D1110 |
Prophylaxis - adult |
235 |
223 |
$7K |
| D7140 |
Extraction, erupted tooth or exposed root |
92 |
26 |
$5K |
| D1351 |
Sealant - per tooth |
536 |
98 |
$5K |
| 92551 |
|
1,655 |
1,051 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
204 |
193 |
$5K |
| 99401 |
|
242 |
231 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,643 |
1,035 |
$4K |
| 90656 |
|
351 |
335 |
$4K |
| 90746 |
|
83 |
48 |
$3K |
| D0330 |
Panoramic radiographic image |
74 |
73 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
181 |
180 |
$3K |
| 0071A |
|
71 |
71 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
516 |
360 |
$2K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
47 |
24 |
$2K |
| D0274 |
Bitewings - four radiographic images |
112 |
111 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
156 |
131 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
111 |
111 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
116 |
91 |
$1K |
| D1120 |
Prophylaxis - child |
86 |
75 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
37 |
24 |
$1K |
| 99381 |
|
105 |
86 |
$1K |
| 99173 |
|
831 |
588 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
57 |
40 |
$930.30 |
| 90677 |
|
334 |
246 |
$894.12 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
129 |
95 |
$714.09 |
| 0072A |
|
16 |
16 |
$691.80 |
| D1208 |
Topical application of fluoride, excluding varnish |
103 |
76 |
$666.68 |
| 99442 |
|
53 |
31 |
$548.07 |
| 3077F |
|
241 |
146 |
$450.00 |
| 90474 |
|
91 |
48 |
$412.24 |
| 3046F |
|
605 |
393 |
$340.04 |
| 90715 |
|
21 |
12 |
$312.63 |
| 90633 |
|
273 |
166 |
$307.83 |
| 0011A |
|
20 |
20 |
$304.64 |
| D0220 |
Intraoral - periapical first radiographic image |
83 |
82 |
$295.00 |
| 3079F |
|
183 |
113 |
$260.00 |
| 90670 |
|
1,351 |
761 |
$250.14 |
| 82044 |
|
271 |
221 |
$240.41 |
| D0272 |
Bitewings - two radiographic images |
24 |
24 |
$240.00 |
| 3074F |
|
174 |
112 |
$240.00 |
| 81003 |
|
251 |
134 |
$202.15 |
| 81025 |
|
179 |
146 |
$195.46 |
| 3080F |
|
84 |
52 |
$145.00 |
| 99383 |
|
40 |
39 |
$135.74 |
| 11721 |
|
19 |
13 |
$115.90 |
| 3044F |
|
107 |
79 |
$100.00 |
| 90674 |
|
53 |
42 |
$64.56 |
| 85018 |
|
55 |
33 |
$51.42 |
| 81002 |
|
280 |
254 |
$45.98 |
| 3008F |
|
133 |
122 |
$30.00 |
| 3078F |
|
20 |
14 |
$25.00 |
| 87220 |
|
61 |
56 |
$8.80 |
| 87210 |
|
70 |
65 |
$8.80 |
| 91305 |
|
343 |
338 |
$3.04 |
| 91306 |
|
254 |
245 |
$1.91 |
| 91307 |
|
145 |
135 |
$1.34 |
| 91301 |
|
31 |
31 |
$0.25 |
| 1036F |
|
25,210 |
15,244 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
10,115 |
6,479 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
4,461 |
3,818 |
$0.00 |
| G8756 |
No documentation of blood pressure measurement, reason not given |
858 |
480 |
$0.00 |
| 3017F |
|
1,664 |
1,434 |
$0.00 |
| 90744 |
|
273 |
146 |
$0.00 |
| 90698 |
|
528 |
289 |
$0.00 |
| 1123F |
|
394 |
144 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
846 |
538 |
$0.00 |
| 90651 |
|
21 |
14 |
$0.00 |
| 90697 |
|
144 |
125 |
$0.00 |
| 3014F |
|
379 |
338 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
731 |
613 |
$0.00 |
| 93000 |
|
27 |
26 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
16 |
13 |
$0.00 |
| 82962 |
|
15 |
13 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
55 |
42 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
18 |
18 |
$0.00 |
| D1310 |
|
19 |
19 |
$0.00 |
| D1330 |
|
26 |
25 |
$0.00 |
| 3351F |
|
14 |
13 |
$0.00 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
57 |
54 |
$0.00 |
| 90716 |
|
17 |
12 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
8,224 |
5,334 |
$0.00 |
| 4004F |
|
13,751 |
8,446 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
1,914 |
1,156 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
622 |
599 |
$0.00 |
| 3051F |
|
21 |
12 |
$0.00 |
| 90648 |
|
23 |
12 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
5,569 |
4,751 |
$0.00 |
| 90707 |
|
17 |
12 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
114 |
108 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
12 |
12 |
$0.00 |
| 90681 |
|
172 |
110 |
$0.00 |
| 1160F |
|
152 |
94 |
$0.00 |
| 1159F |
|
76 |
37 |
$0.00 |
| 3045F |
|
53 |
50 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
14 |
12 |
$0.00 |
| 4040F |
|
16 |
16 |
$0.00 |
| G8598 |
Aspirin or another antiplatelet therapy used |
139 |
126 |
$0.00 |