| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
10,336 |
8,464 |
$1.93M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43,122 |
35,827 |
$1.23M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,366 |
2,190 |
$89K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,508 |
2,417 |
$69K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,329 |
1,264 |
$64K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,291 |
4,934 |
$49K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
761 |
734 |
$41K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,426 |
1,275 |
$30K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,197 |
2,971 |
$28K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
515 |
479 |
$27K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
943 |
887 |
$26K |
| 90671 |
|
534 |
460 |
$22K |
| 90697 |
|
493 |
422 |
$21K |
| 88142 |
|
1,167 |
1,030 |
$15K |
| 92551 |
|
2,910 |
2,773 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
999 |
951 |
$12K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
10,360 |
9,442 |
$10K |
| 0012A |
|
252 |
251 |
$9K |
| 90658 |
|
527 |
515 |
$8K |
| 81025 |
|
2,824 |
2,487 |
$8K |
| 0011A |
|
224 |
224 |
$8K |
| 99401 |
|
1,331 |
1,291 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
403 |
363 |
$5K |
| 99173 |
|
2,910 |
2,772 |
$4K |
| 81002 |
|
5,579 |
4,367 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
194 |
172 |
$3K |
| 97803 |
|
5,776 |
5,376 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
71 |
71 |
$3K |
| 99490 |
Ccm add 20min |
518 |
512 |
$2K |
| 99381 |
|
123 |
123 |
$2K |
| D1206 |
Topical application of fluoride varnish |
320 |
282 |
$2K |
| D1120 |
Prophylaxis - child |
303 |
271 |
$2K |
| 87590 |
|
667 |
528 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
82 |
77 |
$2K |
| 97802 |
|
1,978 |
1,774 |
$2K |
| D0190 |
|
2,652 |
2,157 |
$2K |
| 82962 |
|
1,765 |
1,645 |
$1K |
| 0013A |
|
38 |
37 |
$1K |
| 90686 |
|
234 |
234 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
163 |
116 |
$1K |
| 99215 |
Prolong outpt/office vis |
94 |
94 |
$1K |
| 90651 |
|
26 |
26 |
$1K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
143 |
100 |
$904.66 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
781 |
721 |
$875.52 |
| D1110 |
Prophylaxis - adult |
203 |
180 |
$850.00 |
| 90619 |
|
14 |
12 |
$840.00 |
| D8670 |
Periodic orthodontic treatment visit |
13 |
13 |
$766.81 |
| 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 |
68 |
68 |
$729.12 |
| 90681 |
|
219 |
200 |
$652.20 |
| 87623 |
|
30 |
30 |
$592.11 |
| 90670 |
|
436 |
394 |
$570.00 |
| 90734 |
|
24 |
24 |
$529.39 |
| 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 |
168 |
158 |
$493.94 |
| 90688 |
|
694 |
596 |
$477.42 |
| 90698 |
|
231 |
192 |
$476.98 |
| 90633 |
|
328 |
289 |
$448.02 |
| 99397 |
|
25 |
25 |
$418.38 |
| 99385 |
|
14 |
12 |
$397.60 |
| 90746 |
|
12 |
12 |
$350.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
98 |
79 |
$299.00 |
| D0220 |
Intraoral - periapical first radiographic image |
574 |
466 |
$274.50 |
| 90685 |
|
80 |
74 |
$225.27 |
| 0503F |
|
121 |
111 |
$225.00 |
| 90716 |
|
28 |
26 |
$140.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
27 |
26 |
$108.91 |
| 90707 |
|
19 |
15 |
$95.20 |
| 87490 |
|
679 |
577 |
$89.70 |
| 90744 |
|
112 |
106 |
$84.36 |
| 86580 |
|
19 |
19 |
$80.14 |
| D0230 |
Intraoral - periapical each additional radiographic image |
778 |
157 |
$67.25 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
76 |
74 |
$27.88 |
| 83986 |
|
73 |
59 |
$22.42 |
| 3078F |
|
357 |
322 |
$17.05 |
| 3074F |
|
318 |
282 |
$16.06 |
| 3044F |
|
153 |
149 |
$14.00 |
| 90750 |
|
65 |
62 |
$12.00 |
| 3079F |
|
67 |
59 |
$4.00 |
| 3075F |
|
70 |
65 |
$3.00 |
| D0274 |
Bitewings - four radiographic images |
31 |
27 |
$0.00 |
| 0502F |
|
18 |
12 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$0.00 |
| H1000 |
Prenatal care, at-risk assessment |
14 |
12 |
$0.00 |
| D1330 |
|
876 |
773 |
$0.00 |
| 99000 |
|
1,045 |
916 |
$0.00 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
35 |
29 |
$0.00 |
| D0602 |
|
29 |
25 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
47 |
37 |
$0.00 |
| 91301 |
|
31 |
31 |
$0.00 |
| D1310 |
|
28 |
25 |
$0.00 |
| 90680 |
|
21 |
18 |
$0.00 |