| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
126,096 |
93,731 |
$26.52M |
| D9999 |
Unspecified adjunctive procedure, by report |
37,458 |
33,439 |
$5.05M |
| D0999 |
Unspecified diagnostic procedure, by report |
15,337 |
13,736 |
$3.27M |
| 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 |
4,134 |
3,671 |
$252K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
5,296 |
4,581 |
$93K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
61,208 |
52,179 |
$65K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27,729 |
24,720 |
$40K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
177 |
153 |
$20K |
| D1999 |
|
53 |
48 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,712 |
3,619 |
$5K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
2,543 |
2,434 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,450 |
7,299 |
$5K |
| 90837 |
Psychotherapy, 53 minutes with patient |
6,580 |
4,638 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
1,043 |
1,002 |
$3K |
| 99490 |
Ccm add 20min |
1,179 |
1,106 |
$3K |
| 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 |
1,065 |
1,009 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,909 |
1,864 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,997 |
3,588 |
$2K |
| 99409 |
|
213 |
121 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
9,424 |
4,645 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
3,858 |
3,698 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,347 |
1,299 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,757 |
1,686 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,963 |
2,753 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,762 |
1,511 |
$2K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
50 |
50 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,025 |
931 |
$1K |
| 91322 |
|
14 |
14 |
$1K |
| 96156 |
|
600 |
557 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,035 |
923 |
$1K |
| 90686 |
|
1,143 |
1,125 |
$878.99 |
| 90677 |
|
82 |
81 |
$840.00 |
| 90651 |
|
186 |
183 |
$822.70 |
| 90734 |
|
139 |
137 |
$789.57 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
133 |
132 |
$768.00 |
| 90656 |
|
365 |
360 |
$677.64 |
| 3074F |
|
5,504 |
4,861 |
$540.00 |
| 3079F |
|
1,659 |
1,489 |
$500.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
605 |
564 |
$478.15 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
238 |
235 |
$461.56 |
| 90716 |
|
436 |
433 |
$416.71 |
| 80305 |
|
364 |
332 |
$414.40 |
| 3078F |
|
4,844 |
4,315 |
$360.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,025 |
972 |
$352.88 |
| 3077F |
|
523 |
456 |
$340.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
710 |
685 |
$330.52 |
| 3075F |
|
842 |
780 |
$320.00 |
| 90619 |
|
32 |
32 |
$315.96 |
| 90707 |
|
434 |
430 |
$306.71 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
446 |
408 |
$282.22 |
| 3044F |
|
150 |
148 |
$220.00 |
| 90715 |
|
236 |
233 |
$217.00 |
| 99442 |
|
619 |
562 |
$206.67 |
| 83655 |
|
1,361 |
1,338 |
$199.89 |
| D0120 |
Periodic oral evaluation - established patient |
15,890 |
15,340 |
$193.14 |
| 90480 |
|
17 |
17 |
$160.72 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,972 |
1,870 |
$158.36 |
| 90474 |
|
176 |
170 |
$151.88 |
| 90696 |
|
167 |
166 |
$117.08 |
| 99384 |
|
20 |
15 |
$105.26 |
| 99385 |
|
15 |
15 |
$102.04 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
188 |
179 |
$97.86 |
| 81002 |
|
874 |
831 |
$96.18 |
| D1206 |
Topical application of fluoride varnish |
19,178 |
18,533 |
$89.18 |
| 90633 |
|
478 |
472 |
$82.45 |
| D1110 |
Prophylaxis - adult |
5,350 |
5,204 |
$81.89 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
794 |
770 |
$73.76 |
| 85018 |
|
1,800 |
1,763 |
$73.31 |
| 36416 |
|
2,817 |
2,741 |
$72.91 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
924 |
868 |
$68.16 |
| 99201 |
|
109 |
105 |
$66.17 |
| D0274 |
Bitewings - four radiographic images |
4,746 |
4,558 |
$58.88 |
| 90648 |
|
675 |
670 |
$56.68 |
| 90473 |
|
259 |
258 |
$52.36 |
| 87280 |
|
402 |
383 |
$51.12 |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$40.65 |
| 3051F |
|
14 |
14 |
$40.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
1,061 |
750 |
$39.12 |
| 96158 |
|
679 |
497 |
$38.16 |
| D0220 |
Intraoral - periapical first radiographic image |
3,227 |
3,079 |
$26.68 |
| 99173 |
|
1,234 |
1,190 |
$25.35 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,985 |
4,760 |
$21.05 |
| 86803 |
|
28 |
26 |
$20.28 |
| 96159 |
|
302 |
192 |
$19.08 |
| 83026 |
|
1,863 |
1,820 |
$16.75 |
| 90670 |
|
139 |
138 |
$16.71 |
| 90680 |
|
546 |
538 |
$16.71 |
| 90723 |
|
504 |
500 |
$16.71 |
| 81025 |
|
40 |
38 |
$16.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
67 |
59 |
$3.32 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
147 |
142 |
$1.35 |
| D0140 |
Limited oral evaluation - problem focused |
2,814 |
2,685 |
$0.01 |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
1,320 |
850 |
$0.00 |
| 4040F |
|
2,406 |
1,829 |
$0.00 |
| 1159F |
|
7,198 |
6,046 |
$0.00 |
| D1120 |
Prophylaxis - child |
13,871 |
13,336 |
$0.00 |
| D1354 |
|
1,369 |
599 |
$0.00 |
| D0330 |
Panoramic radiographic image |
1,824 |
1,734 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,632 |
1,769 |
$0.00 |
| 2028F |
|
14 |
14 |
$0.00 |
| 4004F |
|
124 |
122 |
$0.00 |
| 99188 |
|
141 |
139 |
$0.00 |
| 1160F |
|
7,199 |
6,047 |
$0.00 |
| 4274F |
|
3,528 |
2,550 |
$0.00 |
| 90461 |
|
23 |
23 |
$0.00 |
| 90700 |
|
162 |
160 |
$0.00 |
| D4910 |
|
135 |
135 |
$0.00 |
| D2140 |
|
165 |
118 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
51 |
50 |
$0.00 |
| 90836 |
|
18 |
13 |
$0.00 |
| 87634 |
|
13 |
13 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
21 |
13 |
$0.00 |
| 3046F |
|
27 |
27 |
$0.00 |
| 90681 |
|
45 |
44 |
$0.00 |
| 54150 |
|
27 |
26 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
29 |
28 |
$0.00 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
25 |
16 |
$0.00 |
| 3045F |
|
12 |
12 |
$0.00 |
| D0602 |
|
5,330 |
5,134 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
4,103 |
3,918 |
$0.00 |
| 2010F |
|
10,211 |
8,452 |
$0.00 |
| 3353F |
|
463 |
402 |
$0.00 |
| D1351 |
Sealant - per tooth |
14,238 |
2,280 |
$0.00 |
| 1126F |
|
948 |
868 |
$0.00 |
| 99460 |
|
341 |
333 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
767 |
362 |
$0.00 |
| D0601 |
|
7,898 |
7,598 |
$0.00 |
| 1034F |
|
1,884 |
1,494 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,170 |
1,533 |
$0.00 |
| 4037F |
|
815 |
807 |
$0.00 |
| 3080F |
|
495 |
442 |
$0.00 |
| G0506 |
Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) |
3,155 |
2,669 |
$0.00 |
| D0603 |
|
6,141 |
5,901 |
$0.00 |
| 3008F |
|
8,491 |
7,193 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
53 |
53 |
$0.00 |
| 4010F |
|
1,048 |
726 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
1,571 |
1,502 |
$0.00 |
| D1330 |
|
14,746 |
14,101 |
$0.00 |
| 2001F |
|
8,835 |
7,481 |
$0.00 |
| 1036F |
|
6,780 |
5,633 |
$0.00 |
| 3351F |
|
1,849 |
1,587 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
19 |
15 |
$0.00 |
| D1353 |
|
143 |
50 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
12 |
12 |
$0.00 |
| 99462 |
|
79 |
61 |
$0.00 |
| D7111 |
|
300 |
218 |
$0.00 |
| D9995 |
|
79 |
70 |
$0.00 |
| 1125F |
|
936 |
850 |
$0.00 |
| 2000F |
|
6,990 |
6,009 |
$0.00 |
| D1310 |
|
286 |
286 |
$0.00 |
| 99383 |
|
15 |
13 |
$0.00 |
| D2331 |
|
51 |
28 |
$0.00 |
| D2330 |
|
32 |
24 |
$0.00 |
| 3352F |
|
916 |
796 |
$0.00 |
| 99441 |
|
94 |
89 |
$0.00 |
| 90688 |
|
53 |
52 |
$0.00 |
| 90697 |
|
25 |
25 |
$0.00 |