| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
12,987 |
9,908 |
$1.75M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19,560 |
11,044 |
$209K |
| 00003 |
Internal/system code - not a standard HCPCS code |
915 |
512 |
$131K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,603 |
2,200 |
$68K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,112 |
788 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
360 |
306 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,551 |
1,124 |
$5K |
| 98940 |
|
700 |
377 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,013 |
654 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,143 |
790 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
606 |
420 |
$1K |
| 90736 |
|
34 |
30 |
$1K |
| 11721 |
|
112 |
71 |
$1K |
| 97014 |
|
524 |
315 |
$1K |
| 90674 |
|
227 |
187 |
$963.79 |
| 90715 |
|
163 |
127 |
$961.21 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
542 |
425 |
$939.64 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
95 |
69 |
$694.45 |
| 92553 |
|
51 |
32 |
$395.10 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
22 |
16 |
$248.67 |
| 11056 |
|
23 |
14 |
$246.87 |
| 99173 |
|
239 |
173 |
$203.65 |
| 90837 |
Psychotherapy, 53 minutes with patient |
27 |
13 |
$131.97 |
| 85018 |
|
154 |
97 |
$101.81 |
| 81002 |
|
192 |
138 |
$77.40 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
89 |
49 |
$64.35 |
| 82962 |
|
64 |
43 |
$42.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
58 |
52 |
$29.81 |
| 99442 |
|
66 |
52 |
$1.28 |
| D0603 |
|
96 |
96 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
70 |
58 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
146 |
145 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
213 |
208 |
$0.00 |
| D1351 |
Sealant - per tooth |
15 |
14 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
233 |
228 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
37 |
34 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
35 |
32 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
70 |
56 |
$0.00 |
| D1120 |
Prophylaxis - child |
13 |
13 |
$0.00 |
| G0127 |
Trimming of dystrophic nails, any number |
18 |
13 |
$0.00 |
| D1110 |
Prophylaxis - adult |
39 |
39 |
$0.00 |
| D4910 |
|
12 |
12 |
$0.00 |