| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
209,146 |
171,456 |
$56.56M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
102,725 |
67,237 |
$42K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
42,195 |
24,858 |
$28K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
72,112 |
50,053 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26,504 |
15,650 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17,937 |
10,466 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
6,000 |
5,096 |
$6K |
| 90648 |
|
7,367 |
6,600 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
4,862 |
4,220 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
26,159 |
23,520 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
3,463 |
1,579 |
$2K |
| 90685 |
|
2,780 |
2,402 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
10,137 |
5,794 |
$2K |
| 99383 |
|
1,061 |
648 |
$2K |
| T1016 |
Case management, each 15 minutes |
88 |
77 |
$2K |
| 99381 |
|
1,607 |
963 |
$2K |
| 99382 |
|
159 |
96 |
$1K |
| 90723 |
|
4,419 |
3,900 |
$1K |
| 99215 |
Prolong outpt/office vis |
16,981 |
13,915 |
$1K |
| 97802 |
|
1,070 |
882 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
46,668 |
41,782 |
$1K |
| 59025 |
Fetal non-stress test |
4,374 |
1,640 |
$1K |
| 80053 |
Comprehensive metabolic panel |
10,170 |
9,535 |
$949.84 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,499 |
6,197 |
$845.13 |
| 86480 |
|
2,046 |
1,866 |
$701.90 |
| 90474 |
|
11,661 |
10,517 |
$658.50 |
| 90633 |
|
6,891 |
6,258 |
$590.74 |
| 99205 |
Prolong outpt/office vis |
811 |
692 |
$467.48 |
| 90715 |
|
4,481 |
4,146 |
$328.38 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
735 |
650 |
$322.61 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
5,923 |
4,227 |
$259.11 |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,607 |
5,253 |
$244.62 |
| D0220 |
Intraoral - periapical first radiographic image |
14,582 |
12,912 |
$237.50 |
| D0140 |
Limited oral evaluation - problem focused |
5,634 |
4,766 |
$227.50 |
| 76801 |
|
2,620 |
1,745 |
$186.90 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
4,670 |
3,278 |
$186.90 |
| 80061 |
Lipid panel |
6,394 |
6,078 |
$52.27 |
| 85027 |
|
3,529 |
3,256 |
$49.17 |
| 0001A |
|
470 |
462 |
$40.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,794 |
1,016 |
$37.51 |
| D1120 |
Prophylaxis - child |
10,243 |
9,050 |
$30.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
14,464 |
13,400 |
$28.14 |
| D0120 |
Periodic oral evaluation - established patient |
9,355 |
8,198 |
$19.00 |
| 81025 |
|
5,876 |
5,363 |
$17.22 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
2,113 |
1,541 |
$17.00 |
| D0272 |
Bitewings - two radiographic images |
5,357 |
4,741 |
$15.00 |
| D1206 |
Topical application of fluoride varnish |
7,550 |
6,802 |
$13.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
10,613 |
8,427 |
$8.00 |
| 90670 |
|
12,399 |
11,280 |
$1.72 |
| 90686 |
|
12,242 |
11,363 |
$0.00 |
| 86901 |
|
2,431 |
2,177 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,012 |
2,814 |
$0.00 |
| 86803 |
|
2,570 |
2,323 |
$0.00 |
| 82728 |
|
537 |
506 |
$0.00 |
| 3074F |
|
5,917 |
5,310 |
$0.00 |
| 82043 |
|
811 |
792 |
$0.00 |
| 86592 |
|
3,903 |
3,600 |
$0.00 |
| 90696 |
|
2,481 |
2,311 |
$0.00 |
| 90680 |
|
11,516 |
10,419 |
$0.00 |
| 1126F |
|
8,159 |
7,378 |
$0.00 |
| 3075F |
|
974 |
943 |
$0.00 |
| D1351 |
Sealant - per tooth |
3,697 |
952 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
4,374 |
4,025 |
$0.00 |
| 87340 |
|
3,082 |
2,781 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
4,503 |
3,779 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,575 |
1,361 |
$0.00 |
| 81001 |
|
1,579 |
1,494 |
$0.00 |
| 83550 |
|
370 |
364 |
$0.00 |
| 85660 |
|
26 |
26 |
$0.00 |
| 86850 |
|
2,549 |
2,284 |
$0.00 |
| 90716 |
|
3,881 |
3,520 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
7,409 |
3,845 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
6,543 |
6,055 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,112 |
4,579 |
$0.00 |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
651 |
599 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
683 |
402 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,594 |
3,064 |
$0.00 |
| 82950 |
|
1,058 |
970 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
32,226 |
29,528 |
$0.00 |
| 90674 |
|
3,292 |
2,601 |
$0.00 |
| 87077 |
|
460 |
396 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,758 |
1,625 |
$0.00 |
| 90697 |
|
2,618 |
2,458 |
$0.00 |
| 83021 |
|
81 |
77 |
$0.00 |
| 3079F |
|
716 |
690 |
$0.00 |
| 85652 |
|
152 |
148 |
$0.00 |
| 90744 |
|
70 |
63 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
9,861 |
9,327 |
$0.00 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
789 |
533 |
$0.00 |
| 81511 |
|
88 |
82 |
$0.00 |
| 86762 |
|
2,281 |
2,050 |
$0.00 |
| 58300 |
|
167 |
89 |
$0.00 |
| 90698 |
|
4,111 |
3,738 |
$0.00 |
| 3049F |
|
14 |
14 |
$0.00 |
| 1125F |
|
1,393 |
1,332 |
$0.00 |
| 83001 |
|
67 |
67 |
$0.00 |
| T1002 |
Rn services, up to 15 minutes |
1,886 |
1,741 |
$0.00 |
| 86780 |
|
1,011 |
871 |
$0.00 |
| 86141 |
|
43 |
42 |
$0.00 |
| 99384 |
|
161 |
98 |
$0.00 |
| 85018 |
|
42 |
41 |
$0.00 |
| H0025 |
Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) |
28 |
27 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
14 |
14 |
$0.00 |
| 82607 |
|
210 |
208 |
$0.00 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
760 |
338 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
229 |
195 |
$0.00 |
| 3044F |
|
168 |
168 |
$0.00 |
| 84270 |
|
29 |
24 |
$0.00 |
| 90381 |
|
185 |
118 |
$0.00 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
347 |
296 |
$0.00 |
| 86706 |
|
25 |
25 |
$0.00 |
| 0072A |
|
321 |
240 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$0.00 |
| 87081 |
|
13 |
12 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
15 |
15 |
$0.00 |
| 86580 |
|
70 |
66 |
$0.00 |
| 82746 |
|
40 |
40 |
$0.00 |
| 90656 |
|
783 |
592 |
$0.00 |
| 3080F |
|
167 |
160 |
$0.00 |
| 0503F |
|
62 |
60 |
$0.00 |
| 3048F |
|
100 |
100 |
$0.00 |
| 90480 |
|
59 |
54 |
$0.00 |
| 83002 |
|
14 |
14 |
$0.00 |
| 84480 |
|
14 |
14 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
24 |
24 |
$0.00 |
| 87430 |
|
87 |
80 |
$0.00 |
| 90677 |
|
74 |
62 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
47 |
31 |
$0.00 |
| 83615 |
|
45 |
42 |
$0.00 |
| 90732 |
|
24 |
24 |
$0.00 |
| 57454 |
|
30 |
14 |
$0.00 |
| 58100 |
|
25 |
15 |
$0.00 |
| 82670 |
|
13 |
13 |
$0.00 |
| 86704 |
|
14 |
14 |
$0.00 |
| 1159F |
|
8,858 |
7,610 |
$0.00 |
| D1354 |
|
1,456 |
531 |
$0.00 |
| 83655 |
|
6,057 |
5,614 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
4,134 |
3,753 |
$0.00 |
| 82248 |
|
304 |
263 |
$0.00 |
| 84702 |
|
239 |
208 |
$0.00 |
| 85610 |
|
617 |
457 |
$0.00 |
| 87653 |
|
2,053 |
1,921 |
$0.00 |
| 82570 |
|
1,649 |
1,545 |
$0.00 |
| 90700 |
|
3,190 |
2,903 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
6,544 |
6,056 |
$0.00 |
| 90734 |
|
2,427 |
2,184 |
$0.00 |
| 90707 |
|
3,556 |
3,241 |
$0.00 |
| 81003 |
|
16,523 |
10,734 |
$0.00 |
| 90649 |
|
3,043 |
2,760 |
$0.00 |
| 87210 |
|
90 |
87 |
$0.00 |
| 86900 |
|
2,431 |
2,177 |
$0.00 |
| 85007 |
|
3,529 |
3,256 |
$0.00 |
| 90671 |
|
2,555 |
2,291 |
$0.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
600 |
569 |
$0.00 |
| 84403 |
|
52 |
50 |
$0.00 |
| 84439 |
|
1,302 |
1,202 |
$0.00 |
| 90710 |
|
2,460 |
2,289 |
$0.00 |
| 3078F |
|
6,573 |
5,903 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
1,516 |
1,308 |
$0.00 |
| 84030 |
|
4,159 |
3,961 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
590 |
327 |
$0.00 |
| D0330 |
Panoramic radiographic image |
1,441 |
1,231 |
$0.00 |
| 97803 |
|
1,131 |
1,108 |
$0.00 |
| 87481 |
|
347 |
296 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
4,362 |
3,729 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
2,330 |
2,247 |
$0.00 |
| 87186 |
|
460 |
396 |
$0.00 |
| 81513 |
|
346 |
295 |
$0.00 |
| 84550 |
|
105 |
99 |
$0.00 |
| D1110 |
Prophylaxis - adult |
2,129 |
1,803 |
$0.00 |
| 90713 |
|
260 |
233 |
$0.00 |
| 90672 |
|
14 |
14 |
$0.00 |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
698 |
445 |
$0.00 |
| 82247 |
|
291 |
250 |
$0.00 |
| 3077F |
|
693 |
655 |
$0.00 |
| 83540 |
|
430 |
420 |
$0.00 |
| H2027 |
Psychoeducational service, per 15 minutes |
194 |
180 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
548 |
200 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
168 |
116 |
$0.00 |
| 0004A |
|
93 |
81 |
$0.00 |
| 86682 |
|
96 |
54 |
$0.00 |
| 0002A |
|
513 |
501 |
$0.00 |
| 84156 |
|
219 |
194 |
$0.00 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
136 |
77 |
$0.00 |
| 80074 |
|
12 |
12 |
$0.00 |
| 1160F |
|
7,747 |
6,965 |
$0.00 |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
14 |
14 |
$0.00 |
| 91321 |
|
21 |
18 |
$0.00 |
| G0109 |
Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes |
27 |
26 |
$0.00 |
| 90380 |
|
153 |
99 |
$0.00 |
| 90681 |
|
42 |
25 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
385 |
375 |
$0.00 |
| 96381 |
|
338 |
217 |
$0.00 |
| 90473 |
|
59 |
56 |
$0.00 |
| 87631 |
|
13 |
13 |
$0.00 |
| 83020 |
|
51 |
26 |
$0.00 |
| 71046 |
Radiologic examination, chest; 2 views |
45 |
39 |
$0.00 |
| 0054A |
|
96 |
89 |
$0.00 |
| 90662 |
|
14 |
14 |
$0.00 |
| 0071A |
|
329 |
253 |
$0.00 |
| 11981 |
|
21 |
14 |
$0.00 |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
62 |
59 |
$0.00 |
| H0031 |
Mental health assessment, by non-physician |
60 |
60 |
$0.00 |
| 84146 |
|
28 |
28 |
$0.00 |
| 86703 |
|
17 |
17 |
$0.00 |
| 91322 |
|
18 |
16 |
$0.00 |