| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,700 |
11,306 |
$467K |
| T1015 |
Clinic visit/encounter, all-inclusive |
525 |
456 |
$95K |
| 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 |
3,861 |
3,267 |
$93K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
868 |
720 |
$64K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,108 |
4,977 |
$61K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,830 |
2,278 |
$60K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
780 |
638 |
$57K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
638 |
575 |
$47K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,089 |
882 |
$32K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
359 |
316 |
$27K |
| 90834 |
Psychotherapy, 45 minutes with patient |
314 |
175 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
575 |
432 |
$16K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
296 |
257 |
$16K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,789 |
1,454 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
597 |
514 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
426 |
271 |
$6K |
| 90651 |
|
445 |
386 |
$5K |
| 90750 |
|
40 |
37 |
$4K |
| 90670 |
|
981 |
770 |
$3K |
| 36416 |
|
2,728 |
2,180 |
$3K |
| 99000 |
|
1,083 |
801 |
$2K |
| 90686 |
|
618 |
572 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
117 |
104 |
$2K |
| 90756 |
|
261 |
231 |
$2K |
| 90715 |
|
187 |
157 |
$2K |
| 90688 |
|
518 |
434 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
1,202 |
984 |
$1K |
| 99381 |
|
20 |
13 |
$937.20 |
| 90620 |
|
38 |
37 |
$701.74 |
| 87320 |
|
227 |
165 |
$684.20 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
71 |
31 |
$525.40 |
| 85018 |
|
177 |
142 |
$500.15 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
17 |
13 |
$410.40 |
| 87073 |
|
227 |
165 |
$408.86 |
| D0120 |
Periodic oral evaluation - established patient |
15 |
12 |
$347.70 |
| 90734 |
|
165 |
156 |
$338.25 |
| D0330 |
Panoramic radiographic image |
45 |
24 |
$316.16 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
19 |
14 |
$290.39 |
| D0210 |
Intraoral - complete series of radiographic images |
19 |
12 |
$202.16 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
16 |
12 |
$183.85 |
| 90723 |
|
540 |
434 |
$167.72 |
| 87210 |
|
50 |
38 |
$134.53 |
| D1206 |
Topical application of fluoride varnish |
27 |
12 |
$133.50 |
| 87220 |
|
33 |
25 |
$125.24 |
| 82570 |
|
53 |
33 |
$114.33 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
49 |
41 |
$103.28 |
| 90707 |
|
27 |
26 |
$99.00 |
| 90662 |
|
65 |
62 |
$95.93 |
| 86580 |
|
15 |
14 |
$79.10 |
| 90648 |
|
744 |
591 |
$62.36 |
| 3044F |
|
97 |
80 |
$60.00 |
| 94760 |
|
59 |
53 |
$54.59 |
| 90633 |
|
134 |
121 |
$48.17 |
| 3045F |
|
75 |
61 |
$40.00 |
| 2022F |
|
1,046 |
886 |
$0.00 |
| 83655 |
|
115 |
89 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
15 |
14 |
$0.00 |
| 90685 |
|
14 |
14 |
$0.00 |
| 81002 |
|
25 |
12 |
$0.00 |
| 87400 |
|
33 |
25 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |
| 90680 |
|
211 |
172 |
$0.00 |
| 90716 |
|
14 |
14 |
$0.00 |
| 90632 |
|
32 |
28 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
174 |
159 |
$0.00 |