| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
32,345 |
25,994 |
$4.85M |
| D0999 |
Unspecified diagnostic procedure, by report |
2,832 |
2,643 |
$549K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,096 |
11,446 |
$528K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,400 |
3,347 |
$250K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,805 |
2,727 |
$245K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,613 |
2,556 |
$201K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,753 |
1,597 |
$136K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,279 |
1,228 |
$74K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,898 |
1,435 |
$68K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,144 |
885 |
$56K |
| 99381 |
|
459 |
442 |
$52K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
922 |
838 |
$45K |
| 90791 |
Psychiatric diagnostic evaluation |
502 |
482 |
$38K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,970 |
3,537 |
$21K |
| 90619 |
|
169 |
165 |
$17K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
172 |
167 |
$17K |
| 99000 |
|
5,010 |
4,542 |
$14K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
100 |
96 |
$14K |
| 90837 |
Psychotherapy, 53 minutes with patient |
142 |
118 |
$9K |
| 87428 |
|
249 |
242 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
546 |
525 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
123 |
121 |
$3K |
| 0001A |
|
99 |
67 |
$3K |
| 90651 |
|
693 |
683 |
$3K |
| 99383 |
|
30 |
30 |
$3K |
| 0002A |
|
53 |
53 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,016 |
7,791 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
198 |
193 |
$2K |
| 99382 |
|
16 |
15 |
$1K |
| 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 |
63 |
57 |
$1K |
| 90686 |
|
3,513 |
3,456 |
$857.44 |
| 81002 |
|
909 |
867 |
$830.31 |
| 81025 |
|
716 |
680 |
$655.08 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
8,551 |
4,916 |
$473.51 |
| 92551 |
|
1,595 |
1,544 |
$414.17 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
28 |
24 |
$300.51 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
126 |
124 |
$261.88 |
| 90621 |
|
37 |
37 |
$225.37 |
| D0330 |
Panoramic radiographic image |
239 |
228 |
$223.80 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
322 |
305 |
$222.53 |
| 90715 |
|
231 |
226 |
$193.99 |
| 0011A |
|
14 |
14 |
$149.08 |
| 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 |
26 |
24 |
$144.84 |
| 90716 |
|
243 |
241 |
$68.00 |
| D0274 |
Bitewings - four radiographic images |
886 |
857 |
$65.76 |
| D1110 |
Prophylaxis - adult |
73 |
72 |
$54.88 |
| D0120 |
Periodic oral evaluation - established patient |
731 |
710 |
$54.82 |
| 90474 |
|
1,008 |
982 |
$43.24 |
| D1208 |
Topical application of fluoride, excluding varnish |
1,892 |
1,858 |
$41.16 |
| 90707 |
|
268 |
266 |
$39.20 |
| 90633 |
|
1,161 |
1,138 |
$30.40 |
| 90744 |
|
802 |
789 |
$30.00 |
| 90656 |
|
123 |
123 |
$17.47 |
| D1206 |
Topical application of fluoride varnish |
202 |
186 |
$13.23 |
| 90473 |
|
162 |
159 |
$7.84 |
| 96160 |
|
180 |
163 |
$2.25 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
27 |
24 |
$1.00 |
| 36416 |
|
1,738 |
1,543 |
$0.00 |
| 90698 |
|
1,198 |
1,181 |
$0.00 |
| 3008F |
|
1,024 |
894 |
$0.00 |
| D0603 |
|
2,045 |
2,021 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,140 |
1,079 |
$0.00 |
| 1126F |
|
619 |
549 |
$0.00 |
| 90696 |
|
268 |
266 |
$0.00 |
| 90697 |
|
342 |
332 |
$0.00 |
| 90680 |
|
1,557 |
1,535 |
$0.00 |
| 3074F |
|
750 |
656 |
$0.00 |
| 90677 |
|
514 |
493 |
$0.00 |
| D1351 |
Sealant - per tooth |
83 |
27 |
$0.00 |
| 96161 |
|
13 |
12 |
$0.00 |
| 3079F |
|
62 |
58 |
$0.00 |
| 96127 |
|
290 |
265 |
$0.00 |
| 91307 |
|
30 |
24 |
$0.00 |
| 1036F |
|
407 |
341 |
$0.00 |
| 91301 |
|
16 |
15 |
$0.00 |
| D0602 |
|
25 |
25 |
$0.00 |
| 1125F |
|
19 |
18 |
$0.00 |
| 3075F |
|
27 |
27 |
$0.00 |
| 90723 |
|
18 |
18 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
757 |
745 |
$0.00 |
| 90670 |
|
1,932 |
1,904 |
$0.00 |
| 90648 |
|
390 |
384 |
$0.00 |
| 90700 |
|
422 |
415 |
$0.00 |
| 3078F |
|
714 |
629 |
$0.00 |
| D1120 |
Prophylaxis - child |
800 |
772 |
$0.00 |
| 90710 |
|
523 |
519 |
$0.00 |
| 90734 |
|
403 |
400 |
$0.00 |
| 99173 |
|
1,938 |
1,877 |
$0.00 |
| 3725F |
|
255 |
234 |
$0.00 |
| 91300 |
|
185 |
139 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
99 |
97 |
$0.00 |
| 91308 |
|
15 |
15 |
$0.00 |