| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
166,773 |
100,102 |
$11.10M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
67,400 |
48,523 |
$1.05M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
32,005 |
23,178 |
$767K |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
761 |
650 |
$754K |
| 90834 |
Psychotherapy, 45 minutes with patient |
14,467 |
7,321 |
$247K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22,320 |
16,594 |
$218K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
5,183 |
4,056 |
$130K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,762 |
1,492 |
$57K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
692 |
643 |
$52K |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,059 |
2,305 |
$49K |
| 90791 |
Psychiatric diagnostic evaluation |
1,729 |
997 |
$43K |
| 99441 |
|
7,210 |
5,526 |
$42K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,405 |
3,383 |
$41K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,412 |
3,471 |
$41K |
| D1110 |
Prophylaxis - adult |
7,394 |
5,435 |
$41K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,964 |
3,190 |
$41K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,204 |
841 |
$40K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,123 |
1,020 |
$39K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,677 |
1,323 |
$36K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,604 |
2,433 |
$29K |
| 11721 |
|
3,014 |
2,296 |
$29K |
| T2003 |
Non-emergency transportation; encounter/trip |
4,013 |
2,045 |
$27K |
| 81025 |
|
7,323 |
5,600 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,073 |
923 |
$24K |
| 99215 |
Prolong outpt/office vis |
685 |
490 |
$23K |
| D0140 |
Limited oral evaluation - problem focused |
6,557 |
4,583 |
$22K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
5,392 |
4,155 |
$19K |
| 90837 |
Psychotherapy, 53 minutes with patient |
778 |
439 |
$19K |
| D0330 |
Panoramic radiographic image |
3,037 |
2,210 |
$18K |
| 90674 |
|
901 |
828 |
$18K |
| 90651 |
|
120 |
114 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
665 |
559 |
$14K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,233 |
605 |
$12K |
| 99442 |
|
975 |
764 |
$12K |
| 99385 |
|
542 |
472 |
$12K |
| D0210 |
Intraoral - complete series of radiographic images |
1,656 |
1,306 |
$12K |
| 11056 |
|
974 |
728 |
$12K |
| 90686 |
|
2,240 |
1,765 |
$11K |
| 0011A |
|
272 |
272 |
$10K |
| D0120 |
Periodic oral evaluation - established patient |
3,959 |
2,655 |
$10K |
| 99201 |
|
1,047 |
786 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
193 |
185 |
$8K |
| 0012A |
|
210 |
209 |
$8K |
| 96160 |
|
6,179 |
4,799 |
$8K |
| 86703 |
|
1,091 |
848 |
$8K |
| 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 |
958 |
758 |
$8K |
| 82962 |
|
6,935 |
5,251 |
$7K |
| D7140 |
Extraction, erupted tooth or exposed root |
793 |
482 |
$7K |
| D0274 |
Bitewings - four radiographic images |
2,764 |
1,911 |
$7K |
| 92551 |
|
2,383 |
2,154 |
$7K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
656 |
580 |
$7K |
| 90670 |
|
223 |
190 |
$6K |
| 90715 |
|
344 |
294 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
862 |
638 |
$6K |
| 81003 |
|
6,922 |
5,075 |
$6K |
| 80305 |
|
1,216 |
919 |
$5K |
| 99386 |
|
137 |
126 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
4,987 |
3,630 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
432 |
366 |
$4K |
| 90734 |
|
64 |
53 |
$3K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
400 |
242 |
$3K |
| 99173 |
|
2,647 |
2,381 |
$3K |
| 99383 |
|
88 |
68 |
$3K |
| D1120 |
Prophylaxis - child |
1,355 |
1,094 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,495 |
706 |
$2K |
| 87650 |
|
252 |
161 |
$2K |
| 92081 |
|
338 |
276 |
$2K |
| 86580 |
|
524 |
389 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
316 |
216 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,419 |
1,187 |
$2K |
| D4341 |
|
131 |
85 |
$1K |
| 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 |
312 |
277 |
$1K |
| 96127 |
|
646 |
603 |
$1K |
| 11057 |
|
121 |
85 |
$1K |
| 96150 |
|
135 |
125 |
$1K |
| D9995 |
|
787 |
497 |
$993.87 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
69 |
32 |
$900.86 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
54 |
29 |
$863.52 |
| 90732 |
|
15 |
12 |
$862.16 |
| 99382 |
|
32 |
25 |
$795.19 |
| 99384 |
|
33 |
25 |
$685.20 |
| 90682 |
|
59 |
45 |
$637.00 |
| 92015 |
Determination of refractive state |
115 |
79 |
$562.41 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
83 |
59 |
$495.99 |
| 87210 |
|
233 |
145 |
$419.97 |
| 90656 |
|
31 |
31 |
$394.44 |
| 82947 |
|
270 |
155 |
$322.95 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$225.12 |
| D1351 |
Sealant - per tooth |
40 |
12 |
$154.00 |
| D1320 |
|
98 |
80 |
$146.91 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
92 |
88 |
$119.07 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
20 |
13 |
$63.20 |
| 90658 |
|
22 |
13 |
$54.55 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
87 |
66 |
$32.44 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
15 |
12 |
$29.00 |
| D0272 |
Bitewings - two radiographic images |
16 |
14 |
$10.00 |
| 91301 |
|
516 |
503 |
$4.65 |
| 91300 |
|
12 |
12 |
$0.11 |
| 3079F |
|
22,401 |
18,338 |
$0.00 |
| 3080F |
|
9,551 |
7,558 |
$0.00 |
| 3074F |
|
25,085 |
20,483 |
$0.00 |
| 3075F |
|
7,346 |
6,301 |
$0.00 |
| D1310 |
|
376 |
250 |
$0.00 |
| 90680 |
|
15 |
13 |
$0.00 |
| D0170 |
|
289 |
180 |
$0.00 |
| D4342 |
|
25 |
12 |
$0.00 |
| D4355 |
|
257 |
183 |
$0.00 |
| 90744 |
|
48 |
38 |
$0.00 |
| 90698 |
|
61 |
53 |
$0.00 |
| 99443 |
|
15 |
13 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
12 |
$0.00 |
| 3078F |
|
29,661 |
23,940 |
$0.00 |
| 3077F |
|
8,840 |
6,936 |
$0.00 |
| D0190 |
|
61 |
39 |
$0.00 |
| 90661 |
|
43 |
40 |
$0.00 |
| 90633 |
|
126 |
104 |
$0.00 |
| 90461 |
|
1,406 |
620 |
$0.00 |
| 90685 |
|
59 |
37 |
$0.00 |
| D4910 |
|
30 |
24 |
$0.00 |