| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
59,953 |
53,255 |
$11.51M |
| 00003 |
Internal/system code - not a standard HCPCS code |
13,242 |
11,326 |
$3.38M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,303 |
7,440 |
$55K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,016 |
12,645 |
$45K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,870 |
2,643 |
$4K |
| 0011A |
|
23 |
23 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
180 |
138 |
$1K |
| 99221 |
|
31 |
30 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
54 |
44 |
$439.86 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
730 |
694 |
$408.89 |
| 90834 |
Psychotherapy, 45 minutes with patient |
17 |
12 |
$380.76 |
| 99215 |
Prolong outpt/office vis |
102 |
96 |
$283.72 |
| 92551 |
|
721 |
691 |
$205.09 |
| 90686 |
|
814 |
789 |
$192.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
255 |
224 |
$182.70 |
| 90739 |
|
13 |
12 |
$148.67 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
1,168 |
1,097 |
$143.10 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
543 |
526 |
$135.09 |
| 81025 |
|
80 |
77 |
$128.80 |
| 96127 |
|
364 |
314 |
$105.67 |
| 90670 |
|
613 |
595 |
$81.00 |
| 81002 |
|
894 |
773 |
$71.50 |
| 90647 |
|
408 |
392 |
$63.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
361 |
349 |
$37.82 |
| D0120 |
Periodic oral evaluation - established patient |
307 |
229 |
$37.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
580 |
556 |
$32.32 |
| 90723 |
|
437 |
427 |
$27.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
34 |
30 |
$18.00 |
| 90633 |
|
173 |
166 |
$18.00 |
| 90651 |
|
17 |
15 |
$18.00 |
| 90707 |
|
13 |
12 |
$9.00 |
| 90681 |
|
176 |
172 |
$9.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
159 |
152 |
$8.08 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
337 |
329 |
$8.08 |
| 82948 |
|
53 |
48 |
$5.36 |
| 99173 |
|
1,123 |
1,109 |
$4.52 |
| 85018 |
|
33 |
29 |
$2.07 |
| 1159F |
|
1,173 |
1,033 |
$0.00 |
| 0502F |
|
963 |
718 |
$0.00 |
| 90710 |
|
13 |
12 |
$0.00 |
| 3725F |
|
247 |
220 |
$0.00 |
| 1160F |
|
931 |
817 |
$0.00 |
| 90461 |
|
328 |
316 |
$0.00 |
| 3078F |
|
363 |
321 |
$0.00 |
| Z6400 |
|
180 |
176 |
$0.00 |
| Z6500 |
|
38 |
38 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
115 |
74 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
15 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
48 |
36 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
16 |
14 |
$0.00 |
| 90700 |
|
14 |
13 |
$0.00 |
| 99401 |
|
25 |
25 |
$0.00 |
| D1120 |
Prophylaxis - child |
59 |
38 |
$0.00 |
| 3074F |
|
417 |
368 |
$0.00 |
| Z1034 |
|
1,522 |
1,284 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
14 |
12 |
$0.00 |
| 3008F |
|
697 |
627 |
$0.00 |
| 1036F |
|
204 |
166 |
$0.00 |
| Z6406 |
|
305 |
259 |
$0.00 |
| 0501F |
|
48 |
45 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
552 |
158 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
131 |
126 |
$0.00 |
| 97802 |
|
26 |
26 |
$0.00 |
| 3079F |
|
17 |
14 |
$0.00 |
| 99381 |
|
12 |
12 |
$0.00 |
| 86580 |
|
14 |
14 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
30 |
15 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
22 |
12 |
$0.00 |
| D9999 |
Unspecified adjunctive procedure, by report |
28 |
12 |
$0.00 |
| D1330 |
|
49 |
38 |
$0.00 |
| 85032 |
|
20 |
20 |
$0.00 |
| 88720 |
|
16 |
12 |
$0.00 |
| 1170F |
|
16 |
14 |
$0.00 |