| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
680,348 |
446,341 |
$95.62M |
| D0999 |
Unspecified diagnostic procedure, by report |
55,574 |
49,999 |
$5.44M |
| 59410 |
|
758 |
600 |
$711K |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
9,914 |
5,534 |
$668K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
331,624 |
242,754 |
$107K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
158 |
156 |
$101K |
| 0012A |
|
1,942 |
1,920 |
$75K |
| 0011A |
|
2,148 |
2,123 |
$69K |
| D1206 |
Topical application of fluoride varnish |
28,372 |
26,862 |
$66K |
| 0013A |
|
913 |
768 |
$38K |
| 90686 |
|
40,395 |
34,106 |
$35K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
24,874 |
22,958 |
$25K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
89,549 |
75,137 |
$24K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
965 |
298 |
$23K |
| 0134A |
|
497 |
496 |
$21K |
| 0072A |
|
483 |
445 |
$20K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
670 |
554 |
$19K |
| 0071A |
|
458 |
436 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
373 |
306 |
$19K |
| 0003A |
|
406 |
351 |
$17K |
| 0002A |
|
403 |
359 |
$17K |
| 90791 |
Psychiatric diagnostic evaluation |
15,960 |
12,198 |
$17K |
| 90651 |
|
8,845 |
7,752 |
$14K |
| 90707 |
|
6,234 |
5,295 |
$14K |
| 0001A |
|
322 |
301 |
$12K |
| 99222 |
Initial hospital care, per day, moderate complexity |
240 |
185 |
$12K |
| 92015 |
Determination of refractive state |
1,031 |
624 |
$11K |
| 99460 |
|
271 |
247 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
58,678 |
45,135 |
$10K |
| 90716 |
|
4,719 |
4,126 |
$10K |
| 90715 |
|
12,953 |
11,170 |
$10K |
| D0274 |
Bitewings - four radiographic images |
8,055 |
7,721 |
$10K |
| 90746 |
|
282 |
173 |
$9K |
| D0272 |
Bitewings - two radiographic images |
4,298 |
4,097 |
$9K |
| 59430 |
|
3,326 |
2,587 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
252 |
241 |
$8K |
| D0220 |
Intraoral - periapical first radiographic image |
6,111 |
5,857 |
$7K |
| D0140 |
Limited oral evaluation - problem focused |
5,488 |
5,139 |
$7K |
| 0124A |
|
165 |
146 |
$6K |
| 90734 |
|
2,359 |
1,702 |
$6K |
| 90677 |
|
2,933 |
2,882 |
$6K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
23,038 |
20,743 |
$6K |
| D7140 |
Extraction, erupted tooth or exposed root |
3,336 |
2,362 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
9,062 |
8,181 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
25,124 |
20,441 |
$5K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,800 |
2,412 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27,060 |
23,810 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
3,037 |
2,517 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,479 |
3,066 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
26,105 |
24,631 |
$5K |
| 90633 |
|
9,029 |
7,991 |
$4K |
| D1120 |
Prophylaxis - child |
25,711 |
24,448 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
87 |
78 |
$4K |
| 90710 |
|
5,522 |
4,903 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25,275 |
22,423 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
3,970 |
3,572 |
$4K |
| 0081A |
|
92 |
91 |
$4K |
| 90685 |
|
3,375 |
2,314 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
62,621 |
55,828 |
$4K |
| V2020 |
Frames, purchases |
168 |
141 |
$3K |
| 90670 |
|
12,924 |
11,060 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
18,113 |
16,191 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
8,102 |
7,828 |
$3K |
| D1110 |
Prophylaxis - adult |
2,404 |
2,307 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
24,802 |
21,714 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
93 |
81 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
11,454 |
7,226 |
$2K |
| 90648 |
|
14,530 |
12,643 |
$2K |
| 90733 |
|
4,925 |
4,731 |
$2K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
12,864 |
4,602 |
$2K |
| 0154A |
|
53 |
29 |
$2K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
127 |
104 |
$2K |
| 90723 |
|
11,475 |
9,934 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
31,467 |
28,035 |
$2K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
51 |
42 |
$2K |
| 82947 |
|
42,474 |
35,651 |
$2K |
| 85018 |
|
74,959 |
66,185 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26,737 |
23,373 |
$1K |
| 80053 |
Comprehensive metabolic panel |
24,777 |
22,462 |
$1K |
| 90700 |
|
5,090 |
4,415 |
$1K |
| 83655 |
|
15,175 |
14,641 |
$1K |
| 86580 |
|
6,559 |
5,396 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
3,357 |
3,018 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
104 |
85 |
$1K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
14,719 |
13,262 |
$1K |
| D0330 |
Panoramic radiographic image |
710 |
691 |
$1K |
| 81025 |
|
37,664 |
32,588 |
$971.02 |
| 90461 |
|
25,464 |
19,908 |
$956.20 |
| 84443 |
Thyroid stimulating hormone (TSH) |
14,399 |
13,552 |
$938.28 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
28,221 |
25,456 |
$917.84 |
| 99173 |
|
19,402 |
17,437 |
$905.10 |
| D4341 |
|
326 |
213 |
$896.55 |
| 90834 |
Psychotherapy, 45 minutes with patient |
596 |
270 |
$887.28 |
| 87430 |
|
11,697 |
10,611 |
$864.10 |
| 90681 |
|
6,046 |
5,572 |
$850.47 |
| 80061 |
Lipid panel |
18,961 |
17,447 |
$836.42 |
| 81000 |
|
40,487 |
32,798 |
$771.44 |
| 90696 |
|
4,163 |
3,843 |
$690.57 |
| 90732 |
|
235 |
169 |
$681.08 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
4,750 |
4,609 |
$660.60 |
| 90680 |
|
2,776 |
2,042 |
$639.07 |
| 87660 |
|
5,581 |
4,289 |
$526.49 |
| 86480 |
|
1,979 |
1,832 |
$493.55 |
| 99383 |
|
1,914 |
1,678 |
$471.84 |
| 71046 |
Radiologic examination, chest; 2 views |
37 |
25 |
$434.21 |
| 99215 |
Prolong outpt/office vis |
4,184 |
3,834 |
$424.78 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
13 |
12 |
$417.73 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
6,007 |
4,744 |
$373.01 |
| 99382 |
|
830 |
695 |
$360.05 |
| 91321 |
|
64 |
61 |
$334.97 |
| 59025 |
Fetal non-stress test |
1,906 |
1,364 |
$325.01 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
11,458 |
10,676 |
$325.00 |
| 86803 |
|
5,959 |
5,758 |
$320.70 |
| 82950 |
|
5,166 |
4,775 |
$318.68 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
64 |
63 |
$318.33 |
| 99381 |
|
2,853 |
2,617 |
$312.07 |
| 84702 |
|
4,473 |
3,790 |
$304.04 |
| 99384 |
|
1,398 |
1,265 |
$297.16 |
| 96160 |
|
6,593 |
5,439 |
$280.60 |
| 80055 |
|
2,797 |
2,594 |
$266.36 |
| 87340 |
|
2,388 |
2,241 |
$248.50 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
676 |
507 |
$240.75 |
| 82728 |
|
6,010 |
5,482 |
$228.57 |
| 82274 |
|
80 |
67 |
$207.30 |
| 86787 |
|
3,797 |
3,482 |
$174.00 |
| 82607 |
|
3,122 |
3,008 |
$169.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
706 |
466 |
$153.52 |
| D1351 |
Sealant - per tooth |
3,042 |
954 |
$144.00 |
| 86592 |
|
4,042 |
2,912 |
$136.85 |
| 99385 |
|
362 |
344 |
$132.80 |
| 87480 |
|
3,411 |
3,315 |
$131.00 |
| 87081 |
|
3,175 |
2,855 |
$129.20 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,085 |
990 |
$128.50 |
| 91322 |
|
41 |
41 |
$120.62 |
| 84439 |
|
1,472 |
1,391 |
$119.22 |
| 96156 |
|
393 |
375 |
$114.60 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,277 |
4,482 |
$113.00 |
| 81001 |
|
4,684 |
4,432 |
$95.18 |
| 93000 |
|
1,676 |
1,452 |
$93.04 |
| 11981 |
|
295 |
271 |
$93.00 |
| 87536 |
|
230 |
209 |
$91.90 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
2,504 |
2,469 |
$86.16 |
| 86706 |
|
972 |
899 |
$84.00 |
| 82746 |
|
1,440 |
1,399 |
$72.30 |
| 90750 |
|
584 |
574 |
$69.11 |
| 83550 |
|
2,579 |
2,460 |
$68.36 |
| 86140 |
|
1,585 |
1,529 |
$60.30 |
| 96150 |
|
1,000 |
696 |
$50.40 |
| 85610 |
|
1,269 |
1,173 |
$45.74 |
| 82043 |
|
1,839 |
1,777 |
$43.88 |
| 94760 |
|
707 |
623 |
$43.00 |
| 84550 |
|
851 |
786 |
$38.10 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
2,197 |
1,878 |
$37.55 |
| 87210 |
|
1,547 |
1,332 |
$36.00 |
| 80076 |
|
1,172 |
1,134 |
$35.70 |
| 85652 |
|
1,529 |
1,465 |
$34.10 |
| 83718 |
|
869 |
773 |
$33.02 |
| D2140 |
|
467 |
338 |
$30.85 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
478 |
436 |
$27.05 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
2,145 |
2,029 |
$26.41 |
| 90713 |
|
141 |
126 |
$25.60 |
| 83735 |
|
840 |
800 |
$22.12 |
| 90473 |
|
108 |
107 |
$22.00 |
| 90660 |
|
80 |
78 |
$22.00 |
| 84153 |
|
821 |
794 |
$21.20 |
| 83540 |
|
63 |
44 |
$6.38 |
| 85660 |
|
1,708 |
1,590 |
$4.66 |
| 86038 |
|
214 |
202 |
$1.00 |
| 82570 |
|
297 |
271 |
$0.00 |
| 84460 |
|
664 |
651 |
$0.00 |
| 84146 |
|
474 |
459 |
$0.00 |
| 3077F |
|
161 |
153 |
$0.00 |
| 82247 |
|
252 |
213 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,379 |
2,992 |
$0.00 |
| 83020 |
|
338 |
336 |
$0.00 |
| 84450 |
|
127 |
122 |
$0.00 |
| 69210 |
|
94 |
85 |
$0.00 |
| 86735 |
|
169 |
159 |
$0.00 |
| 86765 |
|
305 |
295 |
$0.00 |
| 2028F |
|
29 |
29 |
$0.00 |
| 84403 |
|
116 |
114 |
$0.00 |
| 82465 |
|
226 |
223 |
$0.00 |
| D0270 |
|
26 |
25 |
$0.00 |
| 86900 |
|
477 |
349 |
$0.00 |
| 80305 |
|
1,688 |
1,343 |
$0.00 |
| 82747 |
|
296 |
291 |
$0.00 |
| 85007 |
|
70 |
67 |
$0.00 |
| 11982 |
|
67 |
61 |
$0.00 |
| 0502F |
|
128 |
104 |
$0.00 |
| 3046F |
|
33 |
33 |
$0.00 |
| 80074 |
|
112 |
63 |
$0.00 |
| 1159F |
|
1,444 |
1,371 |
$0.00 |
| 99078 |
|
22 |
12 |
$0.00 |
| 4004F |
|
98 |
96 |
$0.00 |
| 80301 |
|
37 |
31 |
$0.00 |
| 4274F |
|
724 |
664 |
$0.00 |
| 3078F |
|
1,726 |
1,616 |
$0.00 |
| D1354 |
|
92 |
43 |
$0.00 |
| 99348 |
|
29 |
25 |
$0.00 |
| 1160F |
|
1,444 |
1,371 |
$0.00 |
| 3051F |
|
23 |
23 |
$0.00 |
| 86694 |
|
26 |
25 |
$0.00 |
| 86431 |
|
27 |
27 |
$0.00 |
| 4040F |
|
269 |
244 |
$0.00 |
| 83516 |
|
14 |
14 |
$0.00 |
| 96153 |
|
29 |
16 |
$0.00 |
| 85045 |
|
12 |
12 |
$0.00 |
| 2001F |
|
878 |
821 |
$0.00 |
| 85027 |
|
829 |
814 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
7,039 |
5,666 |
$0.00 |
| 85730 |
|
352 |
339 |
$0.00 |
| 87070 |
|
124 |
102 |
$0.00 |
| 86361 |
|
82 |
68 |
$0.00 |
| 83001 |
|
428 |
420 |
$0.00 |
| 83880 |
|
197 |
191 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
3,659 |
2,376 |
$0.00 |
| Q3014 |
Telehealth originating site facility fee |
320 |
192 |
$0.00 |
| 83690 |
|
357 |
347 |
$0.00 |
| 86780 |
|
3,259 |
3,167 |
$0.00 |
| 92551 |
|
303 |
270 |
$0.00 |
| 99386 |
|
81 |
64 |
$0.00 |
| 83002 |
|
183 |
180 |
$0.00 |
| 57454 |
|
127 |
121 |
$0.00 |
| 86704 |
|
180 |
180 |
$0.00 |
| D4342 |
|
155 |
111 |
$0.00 |
| 2010F |
|
2,557 |
2,378 |
$0.00 |
| D5899 |
|
112 |
98 |
$0.00 |
| 84402 |
|
27 |
27 |
$0.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
42 |
27 |
$0.00 |
| 3044F |
|
251 |
249 |
$0.00 |
| D9995 |
|
35 |
31 |
$0.00 |
| 3351F |
|
344 |
344 |
$0.00 |
| 90656 |
|
1,297 |
1,272 |
$0.00 |
| 3079F |
|
418 |
395 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
12 |
12 |
$0.00 |
| 3352F |
|
44 |
44 |
$0.00 |
| 1125F |
|
406 |
383 |
$0.00 |
| 94010 |
|
188 |
102 |
$0.00 |
| 2000F |
|
2,264 |
2,087 |
$0.00 |
| 3052F |
|
13 |
13 |
$0.00 |
| 58100 |
|
25 |
24 |
$0.00 |
| 0503F |
|
15 |
13 |
$0.00 |
| 4010F |
|
136 |
124 |
$0.00 |
| 3075F |
|
178 |
177 |
$0.00 |
| 36416 |
|
36 |
36 |
$0.00 |
| 3353F |
|
23 |
21 |
$0.00 |
| 85379 |
|
12 |
12 |
$0.00 |
| 3074F |
|
1,909 |
1,778 |
$0.00 |
| 1036F |
|
1,015 |
969 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
87 |
52 |
$0.00 |
| 3008F |
|
2,498 |
2,304 |
$0.00 |
| 1126F |
|
1,591 |
1,519 |
$0.00 |
| 1034F |
|
204 |
189 |
$0.00 |
| D9310 |
|
21 |
14 |
$0.00 |
| 3080F |
|
108 |
103 |
$0.00 |
| 3048F |
|
27 |
27 |
$0.00 |