| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
31,907 |
26,069 |
$6.41M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,821 |
12,835 |
$365K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,083 |
1,960 |
$71K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
338 |
337 |
$51K |
| 99385 |
|
152 |
152 |
$27K |
| 90834 |
Psychotherapy, 45 minutes with patient |
628 |
414 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
784 |
779 |
$17K |
| D0999 |
Unspecified diagnostic procedure, by report |
855 |
478 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
648 |
645 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
404 |
401 |
$13K |
| 90837 |
Psychotherapy, 53 minutes with patient |
325 |
235 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
455 |
453 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
186 |
185 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
285 |
284 |
$5K |
| 90791 |
Psychiatric diagnostic evaluation |
126 |
126 |
$4K |
| 99383 |
|
97 |
97 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
84 |
84 |
$3K |
| 90832 |
Psychotherapy, 30 minutes with patient |
46 |
39 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
279 |
258 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,258 |
3,227 |
$1K |
| 0002A |
|
32 |
31 |
$1K |
| 97169 |
|
34 |
34 |
$900.00 |
| 86328 |
|
428 |
415 |
$783.18 |
| 0001A |
|
20 |
20 |
$755.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,446 |
1,429 |
$586.00 |
| 0012A |
|
14 |
14 |
$330.51 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
455 |
446 |
$209.20 |
| 87430 |
|
343 |
334 |
$183.56 |
| 0011A |
|
12 |
12 |
$152.46 |
| 99384 |
|
13 |
13 |
$100.43 |
| 81005 |
|
3,971 |
2,759 |
$45.50 |
| 81025 |
|
571 |
564 |
$36.15 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
158 |
158 |
$23.02 |
| 90461 |
|
776 |
768 |
$19.60 |
| 90686 |
|
1,380 |
1,375 |
$17.52 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
649 |
642 |
$14.44 |
| 82948 |
|
268 |
246 |
$4.23 |
| 90619 |
|
89 |
89 |
$0.02 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
1,117 |
1,108 |
$0.00 |
| 90656 |
|
228 |
224 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,519 |
1,490 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
160 |
95 |
$0.00 |
| 96161 |
|
360 |
346 |
$0.00 |
| 90697 |
|
172 |
172 |
$0.00 |
| 90680 |
|
300 |
298 |
$0.00 |
| D0603 |
|
539 |
293 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
47 |
26 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
22 |
14 |
$0.00 |
| 59430 |
|
62 |
59 |
$0.00 |
| 90651 |
|
128 |
127 |
$0.00 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
16 |
15 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
498 |
93 |
$0.00 |
| 96127 |
|
87 |
85 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
16 |
16 |
$0.00 |
| 91301 |
|
12 |
12 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
128 |
128 |
$0.00 |
| 90715 |
|
147 |
146 |
$0.00 |
| 90671 |
|
236 |
236 |
$0.00 |
| 90670 |
|
314 |
313 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
41 |
41 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
46 |
24 |
$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 |
105 |
104 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
154 |
84 |
$0.00 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
32 |
32 |
$0.00 |
| D1120 |
Prophylaxis - child |
44 |
26 |
$0.00 |
| 90734 |
|
30 |
29 |
$0.00 |
| 90633 |
|
183 |
182 |
$0.00 |
| 90648 |
|
38 |
38 |
$0.00 |
| 99173 |
|
15 |
12 |
$0.00 |
| 90710 |
|
26 |
25 |
$0.00 |
| 96160 |
|
12 |
12 |
$0.00 |