| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
129,692 |
99,917 |
$31.14M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
185,220 |
150,902 |
$10.68M |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
69,848 |
61,479 |
$10.30M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
202,372 |
168,568 |
$8.02M |
| 90832 |
Psychotherapy, 30 minutes with patient |
150,480 |
102,178 |
$6.59M |
| G9002 |
Coordinated care fee, maintenance rate |
126,823 |
98,080 |
$5.80M |
| 90834 |
Psychotherapy, 45 minutes with patient |
83,888 |
57,378 |
$5.05M |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
130,669 |
67,804 |
$3.16M |
| 90791 |
Psychiatric diagnostic evaluation |
26,897 |
21,105 |
$2.87M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
54,305 |
45,118 |
$2.11M |
| H2017 |
Psychosocial rehabilitation services, per 15 minutes |
31,237 |
4,662 |
$1.92M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17,641 |
15,734 |
$1.27M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
19,126 |
16,437 |
$1.20M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16,918 |
15,077 |
$1.19M |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
8,898 |
7,956 |
$704K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22,615 |
19,580 |
$628K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
4,556 |
3,552 |
$509K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
4,119 |
3,322 |
$274K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
18,539 |
8,229 |
$244K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
3,343 |
2,327 |
$203K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
6,166 |
5,137 |
$193K |
| H0034 |
Medication training and support, per 15 minutes |
19,279 |
15,028 |
$177K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14,084 |
11,407 |
$152K |
| G9001 |
Coordinated care fee, initial rate |
2,306 |
1,965 |
$150K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12,368 |
10,589 |
$143K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,564 |
1,262 |
$139K |
| 59426 |
|
265 |
246 |
$135K |
| D1206 |
Topical application of fluoride varnish |
6,745 |
6,479 |
$126K |
| 96156 |
|
2,432 |
2,262 |
$112K |
| D1120 |
Prophylaxis - child |
3,459 |
3,360 |
$107K |
| 36415 |
Collection of venous blood by venipuncture |
48,673 |
41,024 |
$105K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,085 |
1,927 |
$97K |
| D1110 |
Prophylaxis - adult |
2,397 |
2,245 |
$94K |
| D0120 |
Periodic oral evaluation - established patient |
3,854 |
3,626 |
$84K |
| D1351 |
Sealant - per tooth |
4,923 |
1,289 |
$84K |
| 99215 |
Prolong outpt/office vis |
2,041 |
1,804 |
$78K |
| 99174 |
|
10,948 |
9,397 |
$71K |
| H0038 |
Self-help/peer services, per 15 minutes |
6,189 |
2,584 |
$71K |
| 59430 |
|
665 |
597 |
$67K |
| 99381 |
|
811 |
733 |
$60K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,091 |
2,013 |
$57K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,718 |
3,089 |
$56K |
| 92250 |
|
2,659 |
2,054 |
$54K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
846 |
551 |
$49K |
| H0016 |
Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) |
465 |
244 |
$49K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
905 |
759 |
$48K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,035 |
3,742 |
$47K |
| 90837 |
Psychotherapy, 53 minutes with patient |
621 |
502 |
$45K |
| D0330 |
Panoramic radiographic image |
1,258 |
1,150 |
$42K |
| D0220 |
Intraoral - periapical first radiographic image |
3,496 |
3,311 |
$35K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,213 |
1,146 |
$34K |
| D0272 |
Bitewings - two radiographic images |
2,609 |
2,515 |
$34K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
452 |
343 |
$34K |
| 92015 |
Determination of refractive state |
2,311 |
1,943 |
$33K |
| D7140 |
Extraction, erupted tooth or exposed root |
690 |
222 |
$33K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
421 |
344 |
$31K |
| 96130 |
|
632 |
458 |
$31K |
| 85018 |
|
12,515 |
10,887 |
$30K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
615 |
508 |
$28K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,098 |
2,723 |
$28K |
| 81025 |
|
4,664 |
3,919 |
$27K |
| 3074F |
|
148,308 |
125,189 |
$27K |
| 99490 |
Ccm add 20min |
4,858 |
4,103 |
$26K |
| 92558 |
|
8,025 |
7,047 |
$26K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,212 |
1,038 |
$23K |
| 90686 |
|
20,884 |
17,824 |
$23K |
| 92552 |
|
1,342 |
1,274 |
$23K |
| 90688 |
|
4,195 |
3,486 |
$23K |
| D0274 |
Bitewings - four radiographic images |
1,325 |
1,224 |
$23K |
| 90715 |
|
1,023 |
914 |
$23K |
| 3008F |
|
179,934 |
148,549 |
$22K |
| 3078F |
|
129,560 |
110,022 |
$20K |
| 92551 |
|
2,846 |
2,518 |
$20K |
| 96167 |
|
494 |
462 |
$20K |
| D0145 |
Oral evaluation for a patient under three years of age |
883 |
871 |
$19K |
| 0012A |
|
516 |
490 |
$18K |
| 81003 |
|
20,934 |
15,358 |
$18K |
| 99484 |
|
478 |
452 |
$17K |
| 0011A |
|
513 |
458 |
$16K |
| 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 |
3,178 |
2,257 |
$16K |
| 96150 |
|
1,335 |
974 |
$15K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
831 |
745 |
$13K |
| 96136 |
|
550 |
400 |
$12K |
| 90651 |
|
3,322 |
2,932 |
$12K |
| 96158 |
|
304 |
269 |
$12K |
| 3079F |
|
38,668 |
32,271 |
$11K |
| 90677 |
|
2,158 |
1,863 |
$10K |
| D2140 |
|
171 |
101 |
$10K |
| 91322 |
|
143 |
117 |
$10K |
| 0031A |
|
298 |
247 |
$9K |
| 99173 |
|
1,996 |
1,751 |
$9K |
| 36416 |
|
7,162 |
6,241 |
$8K |
| 80305 |
|
1,091 |
812 |
$8K |
| 90480 |
|
342 |
260 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
102 |
96 |
$8K |
| 96137 |
|
298 |
215 |
$8K |
| 3075F |
|
10,890 |
9,145 |
$7K |
| 87807 |
|
569 |
471 |
$7K |
| 83655 |
|
529 |
454 |
$7K |
| D0210 |
Intraoral - complete series of radiographic images |
133 |
127 |
$6K |
| 90670 |
|
9,361 |
8,529 |
$6K |
| 90656 |
|
655 |
618 |
$6K |
| 90678 |
|
36 |
26 |
$6K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
71 |
40 |
$5K |
| 96101 |
|
230 |
146 |
$5K |
| 3077F |
|
5,488 |
4,506 |
$5K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
34 |
24 |
$4K |
| 98967 |
|
268 |
212 |
$3K |
| 0072A |
|
90 |
84 |
$3K |
| D0140 |
Limited oral evaluation - problem focused |
195 |
139 |
$3K |
| 80061 |
Lipid panel |
193 |
173 |
$3K |
| 90716 |
|
3,839 |
3,367 |
$3K |
| 59025 |
Fetal non-stress test |
96 |
43 |
$3K |
| V2020 |
Frames, purchases |
246 |
228 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
74 |
54 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
52 |
41 |
$2K |
| 92587 |
|
91 |
84 |
$2K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
615 |
241 |
$2K |
| 90723 |
|
9,954 |
8,897 |
$2K |
| D0190 |
|
311 |
270 |
$2K |
| 90461 |
|
14,679 |
13,155 |
$2K |
| 0071A |
|
56 |
50 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
57 |
45 |
$2K |
| 90619 |
|
734 |
634 |
$2K |
| 90734 |
|
1,059 |
953 |
$2K |
| 90785 |
|
764 |
597 |
$2K |
| 98966 |
|
241 |
167 |
$1K |
| 82465 |
|
621 |
542 |
$1K |
| 0064A |
|
42 |
37 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
175 |
160 |
$1K |
| 96131 |
|
19 |
14 |
$1K |
| 96154 |
|
126 |
75 |
$1K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
245 |
219 |
$1K |
| 90680 |
|
3,684 |
3,330 |
$1K |
| 99382 |
|
14 |
13 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
79 |
57 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
166 |
130 |
$1K |
| 90707 |
|
3,703 |
3,235 |
$1K |
| D1354 |
|
120 |
44 |
$951.94 |
| 90473 |
|
132 |
118 |
$865.61 |
| 0081A |
|
22 |
14 |
$831.35 |
| 90647 |
|
8,231 |
7,484 |
$823.46 |
| 90474 |
|
158 |
127 |
$813.12 |
| 90671 |
|
712 |
650 |
$788.30 |
| 3080F |
|
1,277 |
1,048 |
$740.00 |
| T1016 |
Case management, each 15 minutes |
60 |
31 |
$616.00 |
| 96127 |
|
139 |
123 |
$572.66 |
| 90633 |
|
4,439 |
3,911 |
$569.08 |
| 71046 |
Radiologic examination, chest; 2 views |
48 |
37 |
$522.22 |
| 87070 |
|
71 |
70 |
$510.95 |
| 0051A |
|
13 |
13 |
$480.00 |
| 0052A |
|
12 |
12 |
$480.00 |
| H0049 |
Alcohol and/or drug screening |
36 |
26 |
$408.00 |
| 99605 |
|
20 |
15 |
$375.00 |
| J1631 |
Injection, haloperidol decanoate, per 50 mg |
119 |
74 |
$352.10 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
55 |
50 |
$308.77 |
| 82570 |
|
93 |
80 |
$258.00 |
| 82044 |
|
56 |
50 |
$201.03 |
| 90620 |
|
15 |
15 |
$200.00 |
| 94760 |
|
409 |
282 |
$106.84 |
| 88720 |
|
21 |
15 |
$75.84 |
| 91301 |
|
1,167 |
1,046 |
$73.88 |
| 90700 |
|
462 |
433 |
$52.30 |
| 99408 |
|
7,590 |
5,898 |
$46.68 |
| D0350 |
|
210 |
192 |
$40.16 |
| 99442 |
|
348 |
314 |
$30.33 |
| 3044F |
|
2,131 |
1,962 |
$20.00 |
| 2022F |
|
21 |
16 |
$10.00 |
| T2002 |
Non-emergency transportation; per diem |
156 |
84 |
$7.20 |
| G9005 |
Coordinated care fee, risk adjusted maintenance |
60,192 |
36,682 |
$4.03 |
| G9010 |
Coordinated care fee, risk adjusted maintenance, level 4 |
22,351 |
15,787 |
$0.88 |
| G9004 |
Coordinated care fee, risk adjusted low, initial |
42,592 |
30,298 |
$0.80 |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
16 |
12 |
$0.59 |
| G9006 |
Coordinated care fee, home monitoring |
2,982 |
2,335 |
$0.29 |
| G9011 |
Coordinated care fee, risk adjusted maintenance, level 5 |
8,236 |
6,049 |
$0.24 |
| 4037F |
|
24,545 |
20,896 |
$0.00 |
| 90674 |
|
1,817 |
1,649 |
$0.00 |
| 0501F |
|
424 |
354 |
$0.00 |
| 90696 |
|
379 |
308 |
$0.00 |
| 2023F |
|
2,161 |
1,798 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,016 |
785 |
$0.00 |
| 99441 |
|
87 |
84 |
$0.00 |
| D1310 |
|
159 |
159 |
$0.00 |
| 91307 |
|
189 |
168 |
$0.00 |
| 91306 |
|
42 |
37 |
$0.00 |
| G9007 |
Coordinated care fee, scheduled team conference |
23 |
12 |
$0.00 |
| 91305 |
|
150 |
139 |
$0.00 |
| 91303 |
|
298 |
247 |
$0.00 |
| 99443 |
|
15 |
14 |
$0.00 |
| D9995 |
|
79 |
78 |
$0.00 |
| 59410 |
|
17 |
13 |
$0.00 |
| 90657 |
|
73 |
35 |
$0.00 |
| D1330 |
|
146 |
146 |
$0.00 |
| H0033 |
Oral medication administration, direct observation |
16 |
14 |
$0.00 |
| 90381 |
|
18 |
14 |
$0.00 |
| 0502F |
|
18,812 |
11,430 |
$0.00 |
| 90681 |
|
1,081 |
1,020 |
$0.00 |
| 90685 |
|
570 |
531 |
$0.00 |
| 90672 |
|
284 |
242 |
$0.00 |
| 92588 |
|
140 |
118 |
$0.00 |
| 90661 |
|
1,227 |
987 |
$0.00 |
| 99080 |
|
325 |
258 |
$0.00 |
| 90687 |
|
104 |
90 |
$0.00 |
| D9996 |
|
188 |
179 |
$0.00 |
| 90380 |
|
35 |
28 |
$0.00 |
| 91321 |
|
30 |
26 |
$0.00 |
| 91308 |
|
24 |
15 |
$0.00 |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
22 |
17 |
$0.00 |
| 90658 |
|
14 |
14 |
$0.00 |