| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
15,270 |
11,509 |
$2.75M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,078 |
12,611 |
$143K |
| 90677 |
|
549 |
532 |
$86K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,009 |
989 |
$47K |
| D0120 |
Periodic oral evaluation - established patient |
294 |
237 |
$43K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,647 |
1,588 |
$36K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
836 |
816 |
$34K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
697 |
679 |
$33K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,489 |
1,269 |
$28K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,652 |
3,568 |
$26K |
| 99429 |
|
2,607 |
2,516 |
$26K |
| 90619 |
|
212 |
209 |
$25K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,923 |
1,894 |
$18K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
747 |
711 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
826 |
762 |
$13K |
| 99188 |
|
734 |
713 |
$12K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
336 |
320 |
$11K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
120 |
113 |
$8K |
| 96127 |
|
6,632 |
5,810 |
$8K |
| 90651 |
|
153 |
151 |
$7K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
556 |
238 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
183 |
172 |
$6K |
| 90710 |
|
240 |
228 |
$5K |
| 98940 |
|
646 |
323 |
$5K |
| 3008F |
|
895 |
839 |
$5K |
| 90461 |
|
258 |
245 |
$4K |
| 90656 |
|
464 |
457 |
$3K |
| 90671 |
|
19 |
19 |
$3K |
| 90686 |
|
947 |
904 |
$3K |
| 97802 |
|
45 |
42 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
502 |
502 |
$1K |
| 90633 |
|
468 |
438 |
$1K |
| 90649 |
|
31 |
31 |
$1K |
| 96160 |
|
1,109 |
1,015 |
$1K |
| 90681 |
|
253 |
221 |
$795.24 |
| 90474 |
|
88 |
88 |
$774.16 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
135 |
131 |
$766.27 |
| 90715 |
|
134 |
133 |
$720.12 |
| 97803 |
|
17 |
13 |
$679.49 |
| 90698 |
|
462 |
395 |
$452.93 |
| 96156 |
|
15 |
15 |
$423.40 |
| 90744 |
|
379 |
342 |
$196.39 |
| 90716 |
|
26 |
26 |
$174.32 |
| 90648 |
|
225 |
199 |
$91.96 |
| 82962 |
|
316 |
276 |
$89.65 |
| 90696 |
|
14 |
14 |
$62.21 |
| 90700 |
|
46 |
41 |
$27.84 |
| 3078F |
|
433 |
378 |
$4.02 |
| 3074F |
|
305 |
269 |
$4.00 |
| 3077F |
|
270 |
230 |
$2.01 |
| 3079F |
|
255 |
222 |
$2.00 |
| 3080F |
|
98 |
92 |
$2.00 |
| 3075F |
|
147 |
134 |
$1.00 |
| 1126F |
|
14 |
12 |
$1.00 |
| 96381 |
|
23 |
23 |
$0.07 |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,800 |
3,146 |
$0.00 |
| 86580 |
|
12 |
12 |
$0.00 |
| 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 |
32 |
32 |
$0.00 |
| 99381 |
|
145 |
145 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
27 |
27 |
$0.00 |
| 90723 |
|
52 |
51 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$0.00 |
| 90381 |
|
15 |
15 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
73 |
65 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
14 |
14 |
$0.00 |
| 90380 |
|
15 |
14 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
203 |
203 |
$0.00 |
| 81025 |
|
47 |
44 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |