| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,673 |
12,154 |
$1.06M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,412 |
4,770 |
$512K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,442 |
2,185 |
$322K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,396 |
2,130 |
$293K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,504 |
1,701 |
$204K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
482 |
439 |
$56K |
| 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 |
11,784 |
7,238 |
$53K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
986 |
792 |
$45K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
370 |
322 |
$40K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
188 |
170 |
$19K |
| 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 |
1,728 |
1,282 |
$15K |
| D1206 |
Topical application of fluoride varnish |
1,066 |
892 |
$13K |
| D1120 |
Prophylaxis - child |
731 |
623 |
$9K |
| 99381 |
|
84 |
60 |
$7K |
| V2020 |
Frames, purchases |
234 |
156 |
$3K |
| D0330 |
Panoramic radiographic image |
13 |
13 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
17 |
17 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
17 |
14 |
$1K |
| 0001A |
|
171 |
135 |
$1K |
| 0012A |
|
190 |
136 |
$905.37 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
287 |
201 |
$740.45 |
| D0140 |
Limited oral evaluation - problem focused |
21 |
13 |
$507.27 |
| 0002A |
|
109 |
87 |
$502.18 |
| 0011A |
|
125 |
119 |
$470.07 |
| 36415 |
Collection of venous blood by venipuncture |
3,154 |
2,114 |
$408.26 |
| 0072A |
|
38 |
30 |
$394.57 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17 |
13 |
$293.04 |
| 99401 |
|
161 |
135 |
$172.56 |
| 92567 |
|
492 |
433 |
$161.51 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
128 |
107 |
$153.31 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
14 |
14 |
$113.62 |
| 0064A |
|
28 |
13 |
$107.61 |
| 82947 |
|
1,695 |
1,113 |
$90.46 |
| 83655 |
|
225 |
198 |
$65.40 |
| 82962 |
|
37 |
34 |
$44.25 |
| 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 |
237 |
67 |
$42.60 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,603 |
2,305 |
$35.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,987 |
3,492 |
$30.39 |
| 85018 |
|
5,263 |
4,362 |
$17.64 |
| 99173 |
|
3,018 |
2,539 |
$17.28 |
| 81025 |
|
244 |
188 |
$11.70 |
| G0008 |
Administration of influenza virus vaccine |
104 |
103 |
$8.45 |
| 81002 |
|
588 |
448 |
$3.16 |
| 90677 |
|
844 |
769 |
$2.45 |
| 90680 |
|
1,312 |
1,171 |
$2.31 |
| 90633 |
|
895 |
775 |
$1.14 |
| 90698 |
|
299 |
276 |
$0.75 |
| 90696 |
|
193 |
173 |
$0.28 |
| 90723 |
|
830 |
709 |
$0.17 |
| 90700 |
|
82 |
73 |
$0.08 |
| 3079F |
|
489 |
394 |
$0.00 |
| 3074F |
|
715 |
592 |
$0.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
841 |
733 |
$0.00 |
| 1125F |
|
898 |
730 |
$0.00 |
| 90656 |
|
85 |
79 |
$0.00 |
| 81001 |
|
159 |
128 |
$0.00 |
| 96161 |
|
902 |
762 |
$0.00 |
| 1126F |
|
993 |
834 |
$0.00 |
| 90657 |
|
817 |
686 |
$0.00 |
| 1170F |
|
422 |
358 |
$0.00 |
| 92551 |
|
1,464 |
1,290 |
$0.00 |
| 90474 |
|
797 |
720 |
$0.00 |
| D0601 |
|
79 |
60 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
52 |
43 |
$0.00 |
| 90647 |
|
651 |
589 |
$0.00 |
| 3008F |
|
1,133 |
972 |
$0.00 |
| 36416 |
|
1,913 |
1,658 |
$0.00 |
| 94760 |
|
20 |
15 |
$0.00 |
| 90697 |
|
558 |
501 |
$0.00 |
| 90650 |
|
14 |
14 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
157 |
138 |
$0.00 |
| 90651 |
|
139 |
124 |
$0.00 |
| 90688 |
|
27 |
26 |
$0.00 |
| 3080F |
|
76 |
71 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
360 |
332 |
$0.00 |
| 90716 |
|
73 |
66 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
346 |
290 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
29 |
17 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
13 |
13 |
$0.00 |
| 97802 |
|
72 |
62 |
$0.00 |
| 90686 |
|
14 |
12 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
12 |
12 |
$0.00 |
| 17250 |
|
18 |
12 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
76 |
15 |
$0.00 |
| 90744 |
|
17 |
17 |
$0.00 |
| 3075F |
|
22 |
20 |
$0.00 |
| 1160F |
|
1,003 |
865 |
$0.00 |
| 3078F |
|
632 |
525 |
$0.00 |
| 11721 |
|
254 |
73 |
$0.00 |
| 3725F |
|
1,018 |
887 |
$0.00 |
| 1159F |
|
1,623 |
1,318 |
$0.00 |
| 90670 |
|
547 |
489 |
$0.00 |
| 3288F |
|
969 |
836 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
718 |
581 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
66 |
56 |
$0.00 |
| 90715 |
|
64 |
59 |
$0.00 |
| 92553 |
|
116 |
102 |
$0.00 |
| 3077F |
|
445 |
375 |
$0.00 |
| 85014 |
|
1,446 |
1,278 |
$0.00 |
| 90707 |
|
273 |
244 |
$0.00 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
47 |
44 |
$0.00 |
| 96160 |
|
229 |
205 |
$0.00 |
| D0190 |
|
138 |
102 |
$0.00 |
| 90671 |
|
25 |
25 |
$0.00 |
| 90734 |
|
95 |
91 |
$0.00 |
| 1003F |
|
70 |
60 |
$0.00 |
| 90681 |
|
29 |
29 |
$0.00 |
| 90710 |
|
29 |
25 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
13 |
13 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
570 |
496 |
$0.00 |
| 90756 |
|
20 |
17 |
$0.00 |
| 99490 |
Ccm add 20min |
126 |
109 |
$0.00 |
| 90648 |
|
19 |
18 |
$0.00 |
| 92015 |
Determination of refractive state |
20 |
17 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
24 |
13 |
$0.00 |
| A4267 |
Contraceptive supply, condom, male, each |
29 |
24 |
$0.00 |