| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
441,937 |
298,012 |
$62.93M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
10,489 |
6,760 |
$719K |
| D0999 |
Unspecified diagnostic procedure, by report |
1,511 |
1,189 |
$90K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
210,354 |
158,101 |
$70K |
| 0012A |
|
584 |
494 |
$24K |
| 0011A |
|
609 |
513 |
$21K |
| 90651 |
|
5,422 |
4,851 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
59,756 |
45,997 |
$17K |
| 90670 |
|
6,752 |
5,924 |
$17K |
| 90686 |
|
26,669 |
23,479 |
$14K |
| 0001A |
|
297 |
262 |
$13K |
| 0124A |
|
375 |
312 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
37,580 |
33,305 |
$11K |
| 0002A |
|
223 |
197 |
$9K |
| D0120 |
Periodic oral evaluation - established patient |
229 |
229 |
$9K |
| 90649 |
|
482 |
349 |
$8K |
| 0071A |
|
214 |
191 |
$8K |
| 0072A |
|
179 |
177 |
$7K |
| 90710 |
|
2,239 |
2,049 |
$7K |
| 0064A |
|
158 |
143 |
$6K |
| 90734 |
|
3,240 |
2,788 |
$6K |
| 0054A |
|
142 |
140 |
$5K |
| 90715 |
|
4,756 |
4,275 |
$5K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,683 |
1,439 |
$4K |
| 59430 |
|
1,018 |
859 |
$4K |
| 90620 |
|
416 |
373 |
$4K |
| 90832 |
Psychotherapy, 30 minutes with patient |
23,614 |
15,021 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12,089 |
10,735 |
$3K |
| 90633 |
|
6,052 |
5,266 |
$3K |
| 90716 |
|
2,877 |
2,517 |
$3K |
| 0003A |
|
69 |
69 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
3,043 |
2,662 |
$3K |
| 0154A |
|
80 |
54 |
$3K |
| 90647 |
|
5,864 |
5,206 |
$3K |
| 91320 |
|
81 |
81 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
6,139 |
5,699 |
$2K |
| 0134A |
|
61 |
56 |
$2K |
| 90696 |
|
2,048 |
1,882 |
$2K |
| 90707 |
|
2,536 |
2,207 |
$2K |
| 0081A |
|
42 |
41 |
$2K |
| 90723 |
|
5,876 |
5,259 |
$1K |
| 90680 |
|
5,037 |
4,491 |
$1K |
| 0052A |
|
25 |
25 |
$1K |
| 90700 |
|
2,187 |
1,958 |
$879.27 |
| 90834 |
Psychotherapy, 45 minutes with patient |
5,794 |
3,981 |
$875.14 |
| 0053A |
|
20 |
20 |
$752.40 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
11,728 |
10,313 |
$708.11 |
| 99201 |
|
842 |
642 |
$672.40 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
7,411 |
6,720 |
$624.49 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,633 |
1,568 |
$581.88 |
| D1120 |
Prophylaxis - child |
413 |
411 |
$548.52 |
| 0051A |
|
14 |
14 |
$543.40 |
| 91318 |
|
151 |
147 |
$478.83 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
10,146 |
8,598 |
$437.14 |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,553 |
1,714 |
$404.24 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
190 |
145 |
$398.24 |
| 0074A |
|
15 |
15 |
$376.20 |
| 91319 |
|
95 |
95 |
$365.51 |
| D1206 |
Topical application of fluoride varnish |
463 |
461 |
$353.66 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
10,858 |
9,911 |
$346.58 |
| 90744 |
|
732 |
680 |
$334.19 |
| 92551 |
|
20,215 |
18,186 |
$319.20 |
| 96152 |
|
743 |
407 |
$304.64 |
| 90713 |
|
762 |
704 |
$298.20 |
| 90688 |
|
294 |
256 |
$291.84 |
| 58300 |
|
41 |
39 |
$264.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
81 |
69 |
$215.70 |
| 81025 |
|
9,885 |
8,482 |
$168.75 |
| 93000 |
|
1,950 |
1,768 |
$155.85 |
| J1631 |
Injection, haloperidol decanoate, per 50 mg |
499 |
364 |
$150.30 |
| 0503F |
|
262 |
232 |
$150.00 |
| 99173 |
|
21,876 |
19,666 |
$129.36 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
7,551 |
7,073 |
$106.00 |
| D0274 |
Bitewings - four radiographic images |
29 |
29 |
$104.43 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
41,843 |
36,802 |
$103.64 |
| 99382 |
|
142 |
115 |
$98.65 |
| 99383 |
|
722 |
648 |
$96.60 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
8,529 |
7,583 |
$96.45 |
| 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 |
2,764 |
2,267 |
$94.96 |
| 90461 |
|
620 |
544 |
$88.08 |
| 90685 |
|
419 |
307 |
$87.24 |
| 58301 |
|
25 |
24 |
$84.28 |
| 81002 |
|
6,548 |
5,486 |
$79.40 |
| 82948 |
|
4,168 |
3,058 |
$72.76 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,063 |
1,913 |
$62.80 |
| 87530 |
|
158 |
143 |
$54.00 |
| 90677 |
|
1,153 |
1,106 |
$53.65 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,388 |
1,231 |
$48.93 |
| 85018 |
|
2,827 |
2,472 |
$39.60 |
| 82962 |
|
4,906 |
4,401 |
$36.70 |
| 90656 |
|
2,776 |
2,669 |
$35.44 |
| 90619 |
|
1,463 |
1,390 |
$33.42 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,766 |
1,541 |
$32.15 |
| 99381 |
|
1,907 |
1,824 |
$32.15 |
| 99384 |
|
882 |
787 |
$32.15 |
| G0123 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision |
444 |
327 |
$31.50 |
| 96127 |
|
3,112 |
2,774 |
$30.20 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
998 |
847 |
$20.00 |
| 94150 |
|
990 |
752 |
$17.60 |
| 3051F |
|
1,735 |
1,587 |
$15.00 |
| 86580 |
|
143 |
101 |
$12.00 |
| 3078F |
|
16,379 |
14,805 |
$7.00 |
| 81003 |
|
221 |
180 |
$6.54 |
| 3074F |
|
16,762 |
15,048 |
$6.00 |
| 90791 |
Psychiatric diagnostic evaluation |
1,617 |
1,450 |
$4.00 |
| 3077F |
|
5,192 |
4,719 |
$1.00 |
| 4010F |
|
4,134 |
3,825 |
$1.00 |
| 3079F |
|
6,790 |
6,334 |
$1.00 |
| 3075F |
|
4,336 |
4,103 |
$1.00 |
| 1159F |
|
3,573 |
3,095 |
$0.00 |
| 3046F |
|
1,220 |
1,148 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14,991 |
13,082 |
$0.00 |
| 1160F |
|
3,702 |
3,209 |
$0.00 |
| 90473 |
|
277 |
235 |
$0.00 |
| J2426 |
Injection, paliperidone palmitate extended release (invega sustenna), 1 mg |
112 |
104 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
803 |
784 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
135 |
50 |
$0.00 |
| 0502F |
|
1,374 |
813 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
67 |
54 |
$0.00 |
| 69209 |
|
68 |
55 |
$0.00 |
| 90681 |
|
168 |
161 |
$0.00 |
| 99401 |
|
752 |
258 |
$0.00 |
| 1033F |
|
107 |
104 |
$0.00 |
| 11981 |
|
29 |
29 |
$0.00 |
| 90746 |
|
13 |
13 |
$0.00 |
| 90687 |
|
26 |
22 |
$0.00 |
| 99408 |
|
33 |
13 |
$0.00 |
| 3050F |
|
13 |
12 |
$0.00 |
| 96381 |
|
21 |
21 |
$0.00 |
| 3044F |
|
2,561 |
2,448 |
$0.00 |
| 99385 |
|
303 |
266 |
$0.00 |
| 90474 |
|
3,564 |
3,186 |
$0.00 |
| 3080F |
|
3,046 |
2,776 |
$0.00 |
| G8708 |
Patient not prescribed antibiotic |
252 |
229 |
$0.00 |
| 1035F |
|
281 |
221 |
$0.00 |
| 1036F |
|
7,473 |
6,498 |
$0.00 |
| 3052F |
|
950 |
888 |
$0.00 |
| 3008F |
|
17,123 |
15,753 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
291 |
283 |
$0.00 |
| 0500F |
|
240 |
237 |
$0.00 |
| 4015F |
|
400 |
378 |
$0.00 |
| 1126F |
|
483 |
444 |
$0.00 |
| J2680 |
Injection, fluphenazine decanoate, up to 25 mg |
38 |
27 |
$0.00 |
| 1034F |
|
2,939 |
2,274 |
$0.00 |
| 90657 |
|
36 |
36 |
$0.00 |
| 4140F |
|
426 |
403 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
244 |
164 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
3,961 |
3,769 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
16 |
15 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
2,150 |
1,777 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
72 |
72 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
33 |
33 |
$0.00 |
| 96150 |
|
59 |
42 |
$0.00 |
| 99386 |
|
30 |
30 |
$0.00 |
| 90381 |
|
48 |
41 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
19 |
19 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
118 |
73 |
$0.00 |
| 1125F |
|
15 |
14 |
$0.00 |
| 99459 |
|
117 |
115 |
$0.00 |
| D1351 |
Sealant - per tooth |
20 |
12 |
$0.00 |
| J0401 |
Injection, aripiprazole (abilify maintena), 1 mg |
13 |
12 |
$0.00 |