| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
137,237 |
113,131 |
$14.86M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
56,607 |
48,874 |
$2.13M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26,268 |
22,780 |
$1.12M |
| D0999 |
Unspecified diagnostic procedure, by report |
6,158 |
5,676 |
$918K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
10,396 |
10,070 |
$610K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
10,259 |
10,135 |
$552K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,784 |
6,660 |
$371K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
5,054 |
4,869 |
$321K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,461 |
5,077 |
$184K |
| 99381 |
|
2,192 |
2,123 |
$140K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,489 |
2,386 |
$114K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,060 |
1,866 |
$112K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16,404 |
7,416 |
$92K |
| 59430 |
|
726 |
687 |
$66K |
| 99383 |
|
967 |
945 |
$64K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,204 |
1,032 |
$62K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
94 |
85 |
$54K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
870 |
789 |
$48K |
| 99382 |
|
741 |
727 |
$46K |
| 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 |
1,558 |
1,458 |
$43K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,080 |
1,021 |
$42K |
| 99000 |
|
22,715 |
21,596 |
$42K |
| 99384 |
|
677 |
657 |
$41K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,944 |
1,824 |
$30K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
437 |
394 |
$20K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
8,622 |
8,353 |
$18K |
| 90461 |
|
16,835 |
4,419 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
8,141 |
7,666 |
$17K |
| 90620 |
|
940 |
899 |
$17K |
| 90832 |
Psychotherapy, 30 minutes with patient |
506 |
397 |
$16K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
544 |
515 |
$15K |
| 90715 |
|
2,840 |
2,670 |
$14K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
349 |
334 |
$13K |
| 87428 |
|
2,838 |
2,729 |
$9K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,275 |
2,195 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,253 |
1,126 |
$7K |
| 99215 |
Prolong outpt/office vis |
117 |
113 |
$6K |
| 81003 |
|
6,737 |
4,303 |
$5K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
259 |
257 |
$4K |
| 90686 |
|
6,009 |
5,885 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14,171 |
13,801 |
$3K |
| 90688 |
|
839 |
825 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
8,385 |
8,242 |
$3K |
| 81002 |
|
4,042 |
3,756 |
$2K |
| 81025 |
|
2,962 |
2,688 |
$2K |
| 90619 |
|
117 |
112 |
$2K |
| 76801 |
|
43 |
37 |
$2K |
| 90677 |
|
1,836 |
1,822 |
$2K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
404 |
398 |
$1K |
| 99385 |
|
16 |
14 |
$924.96 |
| 90651 |
|
3,386 |
3,309 |
$884.67 |
| 90656 |
|
1,267 |
1,252 |
$856.03 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
33 |
32 |
$629.73 |
| 87807 |
|
106 |
104 |
$627.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
12 |
$607.13 |
| 90734 |
|
2,373 |
2,314 |
$549.34 |
| 86703 |
|
566 |
526 |
$466.15 |
| 92551 |
|
8,565 |
8,378 |
$436.10 |
| 0001A |
|
63 |
63 |
$400.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
440 |
420 |
$384.63 |
| 90670 |
|
5,688 |
5,633 |
$356.82 |
| 0071A |
|
117 |
117 |
$280.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
58 |
54 |
$278.96 |
| 90707 |
|
1,909 |
1,879 |
$228.11 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
189 |
185 |
$222.53 |
| 90681 |
|
2,283 |
2,262 |
$203.62 |
| 90710 |
|
2,011 |
1,983 |
$203.62 |
| 0002A |
|
31 |
30 |
$160.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
210 |
205 |
$153.99 |
| 0011A |
|
12 |
12 |
$135.52 |
| D1110 |
Prophylaxis - adult |
494 |
483 |
$109.76 |
| 87420 |
|
22 |
20 |
$93.44 |
| 90723 |
|
2,479 |
2,459 |
$88.38 |
| 85018 |
|
2,925 |
2,869 |
$85.79 |
| D0120 |
Periodic oral evaluation - established patient |
1,151 |
1,116 |
$57.70 |
| 92587 |
|
578 |
573 |
$53.60 |
| 85610 |
|
46 |
42 |
$50.40 |
| D1206 |
Topical application of fluoride varnish |
3,171 |
3,078 |
$44.10 |
| 90662 |
|
12 |
12 |
$40.00 |
| D1120 |
Prophylaxis - child |
2,546 |
2,474 |
$36.75 |
| 82947 |
|
59 |
59 |
$36.30 |
| 93000 |
|
14 |
14 |
$23.56 |
| 84460 |
|
69 |
69 |
$17.80 |
| 84450 |
|
56 |
56 |
$13.05 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
31 |
25 |
$1.30 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
14 |
12 |
$0.96 |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
689 |
670 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
10,757 |
2,045 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
725 |
462 |
$0.00 |
| D0603 |
|
4,551 |
4,338 |
$0.00 |
| D1351 |
Sealant - per tooth |
1,223 |
288 |
$0.00 |
| 90716 |
|
1,907 |
1,881 |
$0.00 |
| 90680 |
|
2,239 |
2,212 |
$0.00 |
| 91307 |
|
183 |
178 |
$0.00 |
| 90697 |
|
3,103 |
3,083 |
$0.00 |
| D0602 |
|
56 |
49 |
$0.00 |
| 90647 |
|
3,504 |
3,463 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
72 |
71 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
641 |
623 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
30 |
29 |
$0.00 |
| 90698 |
|
379 |
375 |
$0.00 |
| 90696 |
|
1,738 |
1,714 |
$0.00 |
| 90744 |
|
14 |
14 |
$0.00 |
| 0072A |
|
33 |
33 |
$0.00 |
| 90381 |
|
40 |
40 |
$0.00 |
| 91301 |
|
87 |
85 |
$0.00 |
| 96158 |
|
382 |
332 |
$0.00 |
| 99173 |
|
7,058 |
6,863 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
943 |
888 |
$0.00 |
| 90700 |
|
1,956 |
1,936 |
$0.00 |
| D0330 |
Panoramic radiographic image |
454 |
443 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
1,072 |
1,050 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
2,176 |
2,096 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
1,893 |
1,828 |
$0.00 |
| 90633 |
|
4,011 |
3,957 |
$0.00 |
| 99490 |
Ccm add 20min |
259 |
257 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
72 |
71 |
$0.00 |
| 99177 |
|
3,672 |
3,615 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
223 |
141 |
$0.00 |
| 90713 |
|
26 |
25 |
$0.00 |
| D0190 |
|
60 |
54 |
$0.00 |
| 91300 |
|
145 |
133 |
$0.00 |