| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 00003 |
Internal/system code - not a standard HCPCS code |
40,542 |
31,702 |
$12.77M |
| T1015 |
Clinic visit/encounter, all-inclusive |
56,572 |
47,673 |
$8.33M |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,883 |
2,019 |
$78K |
| 80305 |
|
7,039 |
2,757 |
$41K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
47,318 |
24,706 |
$39K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
20,558 |
12,060 |
$22K |
| 90686 |
|
1,506 |
1,047 |
$18K |
| 90791 |
Psychiatric diagnostic evaluation |
301 |
166 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,653 |
3,747 |
$6K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,062 |
785 |
$5K |
| 90834 |
Psychotherapy, 45 minutes with patient |
641 |
259 |
$3K |
| 90656 |
|
228 |
151 |
$2K |
| 97802 |
|
13 |
13 |
$2K |
| 0012A |
|
33 |
33 |
$2K |
| 99215 |
Prolong outpt/office vis |
475 |
375 |
$2K |
| H0049 |
Alcohol and/or drug screening |
372 |
372 |
$2K |
| 90715 |
|
80 |
47 |
$1K |
| 0002A |
|
16 |
16 |
$1K |
| 0064A |
|
31 |
31 |
$938.00 |
| 0011A |
|
14 |
14 |
$938.00 |
| 0001A |
|
13 |
13 |
$871.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
214 |
129 |
$749.32 |
| 91322 |
|
172 |
169 |
$729.60 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
48 |
37 |
$693.75 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
22 |
22 |
$550.00 |
| 90746 |
|
17 |
13 |
$449.04 |
| 0134A |
|
32 |
32 |
$402.00 |
| 81015 |
|
285 |
189 |
$387.50 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
60 |
53 |
$315.56 |
| 90480 |
|
183 |
180 |
$280.00 |
| 90662 |
|
31 |
29 |
$233.58 |
| D0230 |
Intraoral - periapical each additional radiographic image |
13 |
13 |
$165.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,064 |
1,039 |
$156.10 |
| D0220 |
Intraoral - periapical first radiographic image |
15 |
15 |
$150.00 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
35 |
15 |
$137.50 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
259 |
248 |
$84.03 |
| 81002 |
|
354 |
245 |
$56.67 |
| 92551 |
|
76 |
43 |
$44.88 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
12 |
$43.85 |
| 81000 |
|
145 |
139 |
$29.02 |
| 99307 |
|
26 |
13 |
$27.40 |
| 99490 |
Ccm add 20min |
751 |
751 |
$0.00 |
| 99442 |
|
319 |
281 |
$0.00 |
| 99173 |
|
50 |
50 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
27 |
14 |
$0.00 |
| 97810 |
|
32 |
30 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
25 |
12 |
$0.00 |
| 91313 |
|
17 |
17 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
45 |
45 |
$0.00 |
| 99441 |
|
26 |
26 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
15 |
15 |
$0.00 |