| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
21,535 |
17,978 |
$1.49M |
| 00003 |
Internal/system code - not a standard HCPCS code |
899 |
899 |
$133K |
| 59425 |
|
1,290 |
870 |
$93K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,604 |
3,544 |
$51K |
| 90791 |
Psychiatric diagnostic evaluation |
224 |
200 |
$32K |
| 90832 |
Psychotherapy, 30 minutes with patient |
515 |
373 |
$29K |
| 90746 |
|
420 |
418 |
$25K |
| 90837 |
Psychotherapy, 53 minutes with patient |
192 |
115 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,232 |
6,757 |
$15K |
| 96127 |
|
2,488 |
2,446 |
$13K |
| 90715 |
|
505 |
497 |
$12K |
| 90686 |
|
1,243 |
1,240 |
$12K |
| D1206 |
Topical application of fluoride varnish |
632 |
628 |
$12K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
129 |
122 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,141 |
1,072 |
$8K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
214 |
197 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,898 |
2,775 |
$7K |
| 0500F |
|
41 |
41 |
$6K |
| 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 |
201 |
183 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
422 |
419 |
$5K |
| 99173 |
|
1,199 |
1,191 |
$5K |
| 99401 |
|
196 |
187 |
$4K |
| J3490 |
Unclassified drugs |
32 |
32 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
307 |
302 |
$2K |
| 90651 |
|
331 |
330 |
$2K |
| 81025 |
|
731 |
709 |
$2K |
| 90707 |
|
95 |
95 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
519 |
517 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
421 |
416 |
$2K |
| 81003 |
|
663 |
550 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
24 |
24 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
411 |
411 |
$1K |
| 87210 |
|
195 |
158 |
$849.73 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
275 |
275 |
$818.92 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
43 |
43 |
$789.86 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
111 |
110 |
$761.91 |
| 97802 |
|
28 |
28 |
$623.98 |
| 96150 |
|
28 |
28 |
$520.00 |
| 90662 |
|
34 |
34 |
$480.00 |
| 90620 |
|
110 |
110 |
$468.00 |
| 92552 |
|
989 |
988 |
$366.03 |
| 97803 |
|
25 |
25 |
$338.86 |
| 90716 |
|
85 |
85 |
$328.00 |
| 99384 |
|
12 |
12 |
$309.84 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
25 |
25 |
$203.16 |
| 86580 |
|
45 |
44 |
$151.20 |
| 96151 |
|
12 |
12 |
$110.99 |
| 90670 |
|
465 |
464 |
$99.00 |
| 90633 |
|
299 |
299 |
$83.43 |
| 90698 |
|
348 |
347 |
$74.16 |
| 99385 |
|
17 |
17 |
$69.21 |
| 99000 |
|
16 |
16 |
$65.40 |
| 90710 |
|
94 |
94 |
$37.08 |
| 90744 |
|
224 |
224 |
$9.27 |
| 85018 |
|
13 |
13 |
$2.48 |
| 90696 |
|
43 |
43 |
$0.00 |
| 90723 |
|
43 |
43 |
$0.00 |
| 90688 |
|
13 |
13 |
$0.00 |
| 90681 |
|
108 |
107 |
$0.00 |
| 90685 |
|
23 |
23 |
$0.00 |
| 90734 |
|
214 |
214 |
$0.00 |
| 90648 |
|
71 |
71 |
$0.00 |