| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
11,611 |
9,008 |
$1.46M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,762 |
4,770 |
$160K |
| D0999 |
Unspecified diagnostic procedure, by report |
679 |
645 |
$115K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
674 |
606 |
$70K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
637 |
594 |
$65K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
654 |
582 |
$61K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,305 |
1,152 |
$52K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
458 |
429 |
$37K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
266 |
241 |
$24K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
664 |
611 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
188 |
174 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,596 |
737 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,036 |
949 |
$6K |
| 99384 |
|
103 |
92 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
126 |
113 |
$3K |
| 99000 |
|
845 |
759 |
$3K |
| 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 |
26 |
25 |
$775.00 |
| 0001A |
|
12 |
12 |
$480.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,495 |
2,204 |
$329.35 |
| D1110 |
Prophylaxis - adult |
50 |
50 |
$316.17 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
73 |
73 |
$269.60 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
54 |
49 |
$267.44 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,039 |
1,188 |
$194.18 |
| 81025 |
|
102 |
85 |
$180.75 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
72 |
69 |
$164.00 |
| D0330 |
Panoramic radiographic image |
13 |
13 |
$121.40 |
| D0120 |
Periodic oral evaluation - established patient |
28 |
28 |
$78.00 |
| 86580 |
|
38 |
31 |
$77.50 |
| 92551 |
|
1,003 |
880 |
$54.32 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$53.30 |
| 90658 |
|
92 |
91 |
$48.36 |
| 90686 |
|
506 |
478 |
$0.02 |
| D1120 |
Prophylaxis - child |
229 |
226 |
$0.00 |
| 99173 |
|
844 |
716 |
$0.00 |
| 90670 |
|
268 |
250 |
$0.00 |
| 90710 |
|
96 |
91 |
$0.00 |
| 90633 |
|
133 |
125 |
$0.00 |
| 90648 |
|
135 |
128 |
$0.00 |
| 90734 |
|
178 |
169 |
$0.00 |
| 91300 |
|
34 |
27 |
$0.00 |
| 90715 |
|
116 |
102 |
$0.00 |
| 90649 |
|
15 |
15 |
$0.00 |
| 90651 |
|
253 |
221 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
356 |
353 |
$0.00 |
| 90688 |
|
253 |
164 |
$0.00 |
| D0601 |
|
212 |
211 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
68 |
63 |
$0.00 |
| 90619 |
|
40 |
26 |
$0.00 |
| 90723 |
|
78 |
68 |
$0.00 |
| D0603 |
|
12 |
12 |
$0.00 |
| 90696 |
|
14 |
14 |
$0.00 |
| 90677 |
|
14 |
14 |
$0.00 |
| 90620 |
|
15 |
15 |
$0.00 |