| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
902,244 |
678,594 |
$244.81M |
| T1016 |
Case management, each 15 minutes |
33,074 |
20,037 |
$780K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
197 |
193 |
$158K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
466 |
461 |
$28K |
| 99460 |
|
475 |
468 |
$27K |
| H0038 |
Self-help/peer services, per 15 minutes |
2,171 |
1,926 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
200,037 |
165,784 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
293,494 |
236,582 |
$12K |
| 59025 |
Fetal non-stress test |
1,193 |
644 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
24,643 |
21,978 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12,587 |
11,287 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
62,570 |
57,678 |
$2K |
| 99463 |
|
32 |
32 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
20,135 |
18,522 |
$2K |
| 99381 |
|
5,996 |
5,522 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
8,271 |
7,354 |
$1K |
| 0012A |
|
1,885 |
1,805 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
19,935 |
18,546 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
6,149 |
5,613 |
$960.24 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
24,000 |
21,388 |
$955.48 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12,306 |
11,379 |
$892.51 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
458 |
415 |
$883.57 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
603 |
552 |
$803.70 |
| 92551 |
|
23,366 |
21,586 |
$468.51 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
2,740 |
2,540 |
$455.98 |
| 76801 |
|
916 |
779 |
$444.76 |
| 76830 |
Ultrasound, transvaginal |
355 |
320 |
$424.96 |
| 0011A |
|
2,015 |
1,907 |
$400.00 |
| 99462 |
|
13 |
12 |
$382.77 |
| 90791 |
Psychiatric diagnostic evaluation |
13,591 |
12,768 |
$357.27 |
| 90686 |
|
23,904 |
21,394 |
$344.34 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
7,270 |
6,892 |
$285.01 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13,192 |
12,084 |
$264.80 |
| 0001A |
|
1,374 |
1,328 |
$240.02 |
| 99215 |
Prolong outpt/office vis |
2,731 |
2,327 |
$204.86 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,881 |
8,365 |
$203.04 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22,518 |
20,665 |
$202.16 |
| 99385 |
|
850 |
755 |
$198.71 |
| 99173 |
|
21,384 |
19,727 |
$189.28 |
| 99383 |
|
1,567 |
1,396 |
$182.27 |
| 90461 |
|
6,103 |
5,279 |
$163.18 |
| 90834 |
Psychotherapy, 45 minutes with patient |
34,734 |
23,815 |
$141.21 |
| 99000 |
|
11,224 |
9,329 |
$124.68 |
| 96152 |
|
3,211 |
1,992 |
$112.96 |
| 90832 |
Psychotherapy, 30 minutes with patient |
35,633 |
22,767 |
$106.30 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,228 |
1,074 |
$105.61 |
| 96156 |
|
8,291 |
7,177 |
$102.74 |
| 81025 |
|
20,043 |
17,684 |
$98.55 |
| 81003 |
|
46,541 |
31,714 |
$92.53 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,088 |
1,801 |
$90.58 |
| 99382 |
|
420 |
377 |
$85.24 |
| 0064A |
|
621 |
585 |
$83.00 |
| 94760 |
|
7,862 |
6,553 |
$70.38 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
7,170 |
6,827 |
$60.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
21,512 |
19,130 |
$55.67 |
| 0002A |
|
916 |
900 |
$40.00 |
| 92587 |
|
2,830 |
2,636 |
$34.18 |
| 90715 |
|
7,535 |
6,939 |
$32.62 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,195 |
5,614 |
$30.42 |
| 99177 |
|
10,064 |
9,372 |
$18.08 |
| 36416 |
|
18,481 |
15,997 |
$13.88 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
9,301 |
7,559 |
$9.00 |
| 90670 |
|
14,104 |
12,944 |
$6.87 |
| 36415 |
Collection of venous blood by venipuncture |
1,867 |
1,621 |
$5.92 |
| 90710 |
|
4,185 |
3,851 |
$5.76 |
| 81002 |
|
4,475 |
4,060 |
$3.20 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
252 |
199 |
$2.78 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
430 |
334 |
$2.24 |
| 90698 |
|
8,715 |
8,045 |
$1.11 |
| 90680 |
|
8,895 |
8,156 |
$0.74 |
| 90651 |
|
4,556 |
4,164 |
$0.37 |
| 90744 |
|
4,367 |
4,040 |
$0.37 |
| 90734 |
|
2,628 |
2,348 |
$0.37 |
| 3074F |
|
27,450 |
24,692 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
325 |
225 |
$0.00 |
| 3079F |
|
8,676 |
8,136 |
$0.00 |
| 90647 |
|
2,009 |
1,793 |
$0.00 |
| 90716 |
|
497 |
441 |
$0.00 |
| 90696 |
|
1,325 |
1,203 |
$0.00 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
1,519 |
1,069 |
$0.00 |
| 91303 |
|
195 |
178 |
$0.00 |
| 93000 |
|
1,911 |
1,727 |
$0.00 |
| 3080F |
|
1,913 |
1,796 |
$0.00 |
| 3075F |
|
5,022 |
4,809 |
$0.00 |
| 91301 |
|
2,997 |
2,500 |
$0.00 |
| 90620 |
|
587 |
538 |
$0.00 |
| 90619 |
|
328 |
308 |
$0.00 |
| 82962 |
|
2,507 |
2,089 |
$0.00 |
| 0134A |
|
153 |
145 |
$0.00 |
| 90697 |
|
1,241 |
1,192 |
$0.00 |
| 85018 |
|
2,107 |
1,928 |
$0.00 |
| 97802 |
|
3,544 |
3,129 |
$0.00 |
| 90723 |
|
1,191 |
1,018 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
1,409 |
1,341 |
$0.00 |
| 96150 |
|
476 |
310 |
$0.00 |
| 90677 |
|
1,132 |
1,095 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
593 |
575 |
$0.00 |
| 99384 |
|
565 |
522 |
$0.00 |
| 3044F |
|
1,444 |
1,331 |
$0.00 |
| 58300 |
|
280 |
247 |
$0.00 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
8,274 |
3,469 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
193 |
161 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
831 |
740 |
$0.00 |
| 91306 |
|
199 |
196 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
432 |
409 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
209 |
176 |
$0.00 |
| 0031A |
|
344 |
325 |
$0.00 |
| 59430 |
|
144 |
141 |
$0.00 |
| 90474 |
|
86 |
64 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
369 |
307 |
$0.00 |
| 91307 |
|
317 |
295 |
$0.00 |
| 90656 |
|
1,283 |
1,053 |
$0.00 |
| 90480 |
|
132 |
106 |
$0.00 |
| Q2039 |
Influenza virus vaccine, not otherwise specified |
81 |
61 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
240 |
199 |
$0.00 |
| 90739 |
|
27 |
25 |
$0.00 |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
55 |
52 |
$0.00 |
| D0603 |
|
66 |
65 |
$0.00 |
| 96154 |
|
50 |
32 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
61 |
57 |
$0.00 |
| 90688 |
|
92 |
81 |
$0.00 |
| 96380 |
|
87 |
87 |
$0.00 |
| 86580 |
|
57 |
54 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
89 |
78 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
37 |
36 |
$0.00 |
| 0072A |
|
352 |
349 |
$0.00 |
| D1330 |
|
51 |
51 |
$0.00 |
| 20610 |
|
30 |
26 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
25 |
25 |
$0.00 |
| 96127 |
|
13 |
13 |
$0.00 |
| 99441 |
|
68 |
60 |
$0.00 |
| 58301 |
|
25 |
25 |
$0.00 |
| 91305 |
|
144 |
111 |
$0.00 |
| 0081A |
|
12 |
12 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
14 |
$0.00 |
| 3052F |
|
30 |
28 |
$0.00 |
| 99499 |
|
6,120 |
5,297 |
$0.00 |
| 91300 |
|
1,904 |
1,559 |
$0.00 |
| 3078F |
|
25,487 |
23,110 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
7,783 |
5,295 |
$0.00 |
| 90633 |
|
6,664 |
6,110 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
30,190 |
18,577 |
$0.00 |
| 96158 |
|
2,025 |
1,704 |
$0.00 |
| 97803 |
|
2,309 |
1,949 |
$0.00 |
| 90700 |
|
602 |
546 |
$0.00 |
| 96160 |
|
25 |
24 |
$0.00 |
| H0031 |
Mental health assessment, by non-physician |
622 |
490 |
$0.00 |
| 3077F |
|
3,321 |
3,121 |
$0.00 |
| D0190 |
|
441 |
426 |
$0.00 |
| D1120 |
Prophylaxis - child |
801 |
750 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
1,176 |
1,052 |
$0.00 |
| 0124A |
|
157 |
146 |
$0.00 |
| 90662 |
|
811 |
748 |
$0.00 |
| 91320 |
|
59 |
41 |
$0.00 |
| 94150 |
|
231 |
193 |
$0.00 |
| 3051F |
|
99 |
94 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
218 |
212 |
$0.00 |
| 90707 |
|
467 |
411 |
$0.00 |
| 90621 |
|
626 |
534 |
$0.00 |
| 3046F |
|
151 |
138 |
$0.00 |
| 91312 |
|
94 |
90 |
$0.00 |
| 91313 |
|
73 |
72 |
$0.00 |
| 0071A |
|
588 |
571 |
$0.00 |
| 0004A |
|
236 |
229 |
$0.00 |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
88 |
87 |
$0.00 |
| 96167 |
|
29 |
29 |
$0.00 |
| 90473 |
|
634 |
504 |
$0.00 |
| 90746 |
|
28 |
27 |
$0.00 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
15 |
12 |
$0.00 |
| 0054A |
|
61 |
58 |
$0.00 |
| 90685 |
|
96 |
88 |
$0.00 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
17 |
14 |
$0.00 |
| D1110 |
Prophylaxis - adult |
26 |
26 |
$0.00 |
| 69210 |
|
21 |
15 |
$0.00 |