| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
19,462 |
15,746 |
$552K |
| Q3014 |
Telehealth originating site facility fee |
2,478 |
2,205 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
144 |
140 |
$3K |
| G0008 |
Administration of influenza virus vaccine |
1,318 |
1,312 |
$3K |
| 90694 |
|
265 |
265 |
$2K |
| 99487 |
Ccm add 20min |
52 |
52 |
$2K |
| 90656 |
|
789 |
781 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,315 |
881 |
$1K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
445 |
441 |
$1K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
703 |
652 |
$984.16 |
| 90834 |
Psychotherapy, 45 minutes with patient |
549 |
346 |
$745.77 |
| 90653 |
|
44 |
44 |
$393.13 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,957 |
1,943 |
$361.11 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
108 |
94 |
$315.65 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
119 |
116 |
$150.90 |
| 91322 |
|
18 |
17 |
$145.92 |
| 82948 |
|
777 |
726 |
$117.32 |
| 90677 |
|
13 |
12 |
$102.57 |
| 90674 |
|
29 |
29 |
$83.59 |
| 84443 |
Thyroid stimulating hormone (TSH) |
266 |
265 |
$49.99 |
| 36415 |
Collection of venous blood by venipuncture |
3,381 |
3,135 |
$47.10 |
| 90480 |
|
18 |
17 |
$45.87 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
58 |
57 |
$35.65 |
| 82962 |
|
2,408 |
2,238 |
$33.03 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
162 |
160 |
$27.74 |
| ATP03 |
|
619 |
574 |
$20.55 |
| Q2036 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) |
14 |
14 |
$16.00 |
| 86803 |
|
42 |
42 |
$11.99 |
| 80061 |
Lipid panel |
1,250 |
1,239 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
1,949 |
1,817 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,148 |
871 |
$0.00 |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
348 |
318 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
1,393 |
1,353 |
$0.00 |
| 81003 |
|
220 |
211 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
172 |
168 |
$0.00 |
| 82570 |
|
191 |
190 |
$0.00 |
| D1110 |
Prophylaxis - adult |
2,140 |
2,092 |
$0.00 |
| 0004A |
|
56 |
56 |
$0.00 |
| 91300 |
|
29 |
28 |
$0.00 |
| D0270 |
|
90 |
86 |
$0.00 |
| 0124A |
|
37 |
37 |
$0.00 |
| D9110 |
|
93 |
80 |
$0.00 |
| 90750 |
|
27 |
27 |
$0.00 |
| 0013A |
|
57 |
56 |
$0.00 |
| 82274 |
|
12 |
12 |
$0.00 |
| D0330 |
Panoramic radiographic image |
41 |
38 |
$0.00 |
| D4341 |
|
45 |
25 |
$0.00 |
| 36416 |
|
2,666 |
2,477 |
$0.00 |
| D9450 |
|
12,753 |
9,350 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
900 |
869 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
531 |
272 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
557 |
533 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
1,966 |
1,895 |
$0.00 |
| 0011A |
|
400 |
400 |
$0.00 |
| 82043 |
|
247 |
246 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
2,626 |
2,364 |
$0.00 |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
327 |
301 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
755 |
739 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
780 |
742 |
$0.00 |
| 91301 |
|
683 |
669 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,017 |
830 |
$0.00 |
| D2331 |
|
31 |
25 |
$0.00 |
| 0012A |
|
389 |
389 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
1,056 |
658 |
$0.00 |
| D1320 |
|
144 |
130 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
37 |
36 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
667 |
646 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
171 |
167 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
94 |
90 |
$0.00 |
| 0064A |
|
243 |
241 |
$0.00 |
| ATP11 |
|
12 |
12 |
$0.00 |
| 0134A |
|
58 |
58 |
$0.00 |
| 86780 |
|
25 |
25 |
$0.00 |
| 85027 |
|
27 |
27 |
$0.00 |
| 94760 |
|
15 |
15 |
$0.00 |
| D9995 |
|
54 |
51 |
$0.00 |
| 91306 |
|
12 |
12 |
$0.00 |
| ATP14 |
|
13 |
13 |
$0.00 |