| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
174,017 |
117,717 |
$25.26M |
| D0999 |
Unspecified diagnostic procedure, by report |
47,539 |
35,879 |
$4.12M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
463 |
248 |
$32K |
| 90651 |
|
5,464 |
4,854 |
$26K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
577 |
202 |
$23K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
15 |
13 |
$16K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
441 |
123 |
$16K |
| 90734 |
|
4,425 |
3,961 |
$14K |
| 90710 |
|
2,259 |
1,971 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
285 |
159 |
$6K |
| 91320 |
|
116 |
111 |
$6K |
| 0011A |
|
164 |
163 |
$5K |
| 0002A |
|
108 |
108 |
$5K |
| 0012A |
|
113 |
111 |
$5K |
| 0001A |
|
94 |
94 |
$4K |
| 0072A |
|
90 |
90 |
$4K |
| 90686 |
|
14,952 |
12,933 |
$4K |
| 0071A |
|
94 |
87 |
$3K |
| 92015 |
Determination of refractive state |
342 |
186 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
19,705 |
14,933 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
61,190 |
48,565 |
$3K |
| 90633 |
|
4,240 |
3,644 |
$3K |
| 90670 |
|
6,072 |
5,016 |
$2K |
| 90696 |
|
2,028 |
1,772 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
59 |
38 |
$2K |
| 91319 |
|
61 |
57 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12,108 |
10,364 |
$934.44 |
| 90715 |
|
2,255 |
2,060 |
$839.94 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
10,048 |
8,210 |
$834.24 |
| 90688 |
|
294 |
260 |
$769.11 |
| 59430 |
|
108 |
107 |
$693.84 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
56 |
42 |
$659.50 |
| 90716 |
|
1,843 |
1,569 |
$637.46 |
| 0502F |
|
13,357 |
7,325 |
$618.40 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
13 |
13 |
$585.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
12 |
12 |
$540.00 |
| 90647 |
|
5,605 |
4,776 |
$510.10 |
| 90649 |
|
114 |
108 |
$485.07 |
| 0503F |
|
399 |
315 |
$475.30 |
| 90707 |
|
1,735 |
1,467 |
$450.68 |
| 90700 |
|
1,722 |
1,477 |
$431.76 |
| 90685 |
|
502 |
367 |
$323.50 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14,527 |
12,940 |
$293.95 |
| 91318 |
|
17 |
17 |
$271.54 |
| 90723 |
|
5,532 |
4,722 |
$232.75 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
529 |
499 |
$211.98 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,011 |
882 |
$176.28 |
| U0001 |
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
58 |
55 |
$143.64 |
| 90744 |
|
34 |
28 |
$90.00 |
| 90680 |
|
3,087 |
2,410 |
$75.29 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
11,245 |
10,017 |
$63.43 |
| 1036F |
|
23,163 |
19,582 |
$42.00 |
| 1160F |
|
49,024 |
41,596 |
$42.00 |
| 3008F |
|
57,255 |
47,717 |
$20.00 |
| 99401 |
|
174 |
98 |
$10.00 |
| 3074F |
|
41,024 |
34,619 |
$3.00 |
| 81025 |
|
6,337 |
5,548 |
$2.58 |
| 3078F |
|
39,137 |
33,218 |
$2.00 |
| 85018 |
|
2,967 |
2,754 |
$1.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
20,902 |
18,724 |
$1.00 |
| 85014 |
|
2,886 |
2,682 |
$1.00 |
| 90621 |
|
31 |
27 |
$0.03 |
| D0140 |
Limited oral evaluation - problem focused |
1,254 |
1,181 |
$0.00 |
| 3080F |
|
196 |
166 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
4,746 |
4,668 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,683 |
3,368 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
27,189 |
21,909 |
$0.00 |
| 99383 |
|
183 |
152 |
$0.00 |
| 90620 |
|
1,116 |
1,088 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
4,504 |
4,067 |
$0.00 |
| 3075F |
|
1,911 |
1,744 |
$0.00 |
| 87428 |
|
1,830 |
1,740 |
$0.00 |
| D9310 |
|
401 |
392 |
$0.00 |
| 3044F |
|
3,065 |
3,029 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,630 |
1,375 |
$0.00 |
| 87081 |
|
1,311 |
1,298 |
$0.00 |
| D0601 |
|
2,590 |
2,524 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,998 |
1,979 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,265 |
5,178 |
$0.00 |
| 99381 |
|
1,906 |
1,721 |
$0.00 |
| 0500F |
|
1,995 |
1,792 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
363 |
361 |
$0.00 |
| 96161 |
|
2,897 |
2,594 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
2,891 |
2,872 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
26,018 |
20,981 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
4,005 |
3,930 |
$0.00 |
| D0603 |
|
1,127 |
1,121 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
219 |
196 |
$0.00 |
| 87480 |
|
631 |
620 |
$0.00 |
| 82950 |
|
564 |
547 |
$0.00 |
| 3079F |
|
4,093 |
3,653 |
$0.00 |
| S5190 |
Wellness assessment, performed by non-physician |
491 |
481 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
1,754 |
1,347 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
5,594 |
5,332 |
$0.00 |
| 85027 |
|
2,407 |
2,356 |
$0.00 |
| D1330 |
|
5,643 |
2,397 |
$0.00 |
| D1310 |
|
612 |
596 |
$0.00 |
| D0602 |
|
1,421 |
1,407 |
$0.00 |
| D1351 |
Sealant - per tooth |
625 |
318 |
$0.00 |
| 96127 |
|
10,555 |
9,467 |
$0.00 |
| 90677 |
|
1,219 |
1,191 |
$0.00 |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
14 |
14 |
$0.00 |
| 81001 |
|
590 |
579 |
$0.00 |
| 86762 |
|
57 |
57 |
$0.00 |
| 86592 |
|
2,383 |
2,354 |
$0.00 |
| 86803 |
|
480 |
479 |
$0.00 |
| 86702 |
|
35 |
34 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,106 |
3,035 |
$0.00 |
| 83550 |
|
178 |
177 |
$0.00 |
| 85730 |
|
14 |
14 |
$0.00 |
| 82728 |
|
230 |
229 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
44 |
44 |
$0.00 |
| 82043 |
|
46 |
46 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
853 |
832 |
$0.00 |
| 82746 |
|
78 |
78 |
$0.00 |
| 82607 |
|
101 |
101 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
470 |
434 |
$0.00 |
| 99384 |
|
35 |
33 |
$0.00 |
| 86005 |
|
58 |
58 |
$0.00 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
63 |
62 |
$0.00 |
| 85652 |
|
40 |
40 |
$0.00 |
| 87340 |
|
41 |
41 |
$0.00 |
| 86780 |
|
29 |
28 |
$0.00 |
| 86850 |
|
47 |
47 |
$0.00 |
| 87070 |
|
90 |
90 |
$0.00 |
| 90839 |
|
15 |
14 |
$0.00 |
| 90656 |
|
1,105 |
1,002 |
$0.00 |
| 99385 |
|
18 |
13 |
$0.00 |
| 90381 |
|
26 |
25 |
$0.00 |
| 86140 |
|
13 |
13 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
49 |
49 |
$0.00 |
| 82784 |
|
13 |
13 |
$0.00 |
| 86255 |
|
13 |
13 |
$0.00 |
| 86901 |
|
46 |
46 |
$0.00 |
| 94760 |
|
16 |
13 |
$0.00 |
| 36416 |
|
12 |
12 |
$0.00 |
| 90657 |
|
53 |
44 |
$0.00 |
| 83735 |
|
14 |
14 |
$0.00 |
| 84439 |
|
276 |
276 |
$0.00 |
| 83655 |
|
3,727 |
3,595 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
666 |
627 |
$0.00 |
| 97803 |
|
12,450 |
12,017 |
$0.00 |
| 3725F |
|
16,863 |
15,046 |
$0.00 |
| D2140 |
|
4,564 |
3,825 |
$0.00 |
| 81002 |
|
3,190 |
2,999 |
$0.00 |
| D0330 |
Panoramic radiographic image |
3,342 |
3,231 |
$0.00 |
| 80061 |
Lipid panel |
4,327 |
4,280 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
1,878 |
1,619 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
4,275 |
3,860 |
$0.00 |
| D1120 |
Prophylaxis - child |
27,299 |
22,013 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,919 |
1,870 |
$0.00 |
| 86003 |
|
106 |
106 |
$0.00 |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
2,066 |
1,603 |
$0.00 |
| 90681 |
|
1,396 |
1,331 |
$0.00 |
| 3077F |
|
909 |
819 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,393 |
4,291 |
$0.00 |
| G9920 |
Screening performed and negative |
3,492 |
3,423 |
$0.00 |
| 84146 |
|
18 |
18 |
$0.00 |
| 86787 |
|
87 |
86 |
$0.00 |
| 85048 |
|
6,124 |
6,074 |
$0.00 |
| 82274 |
|
181 |
180 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
174 |
134 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
59 |
56 |
$0.00 |
| 85004 |
|
40 |
40 |
$0.00 |
| 85610 |
|
14 |
14 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
1,574 |
1,486 |
$0.00 |
| 86480 |
|
396 |
393 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
17 |
16 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
3,570 |
3,504 |
$0.00 |
| 86703 |
|
179 |
154 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
90 |
88 |
$0.00 |
| 87338 |
|
63 |
61 |
$0.00 |
| 82947 |
|
65 |
64 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
49 |
26 |
$0.00 |
| 82570 |
|
66 |
66 |
$0.00 |
| 85045 |
|
16 |
16 |
$0.00 |
| 90687 |
|
13 |
13 |
$0.00 |
| 86900 |
|
46 |
46 |
$0.00 |
| D1110 |
Prophylaxis - adult |
61 |
52 |
$0.00 |
| 83013 |
|
12 |
12 |
$0.00 |
| 90380 |
|
64 |
61 |
$0.00 |
| 84702 |
|
20 |
20 |
$0.00 |
| 83516 |
|
13 |
13 |
$0.00 |