| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
34,390 |
23,590 |
$6.65M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
105,755 |
95,910 |
$2.01M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
22,836 |
22,344 |
$500K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,131 |
11,567 |
$244K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,659 |
3,630 |
$142K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,261 |
2,254 |
$109K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
3,417 |
3,107 |
$88K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,330 |
3,233 |
$84K |
| 90686 |
|
10,942 |
10,750 |
$82K |
| 90461 |
|
4,468 |
4,339 |
$74K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,370 |
1,351 |
$71K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,520 |
2,416 |
$40K |
| 0012A |
|
1,210 |
1,209 |
$40K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,308 |
3,247 |
$36K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,071 |
3,048 |
$36K |
| 92551 |
|
8,283 |
8,205 |
$32K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,273 |
1,964 |
$30K |
| 0011A |
|
1,208 |
1,205 |
$28K |
| 90677 |
|
547 |
544 |
$23K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
533 |
531 |
$22K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,594 |
2,530 |
$17K |
| 82947 |
|
7,987 |
7,522 |
$16K |
| 0064A |
|
500 |
496 |
$16K |
| 0002A |
|
343 |
343 |
$13K |
| 0071A |
|
307 |
306 |
$12K |
| 90651 |
|
343 |
339 |
$11K |
| 97803 |
|
446 |
415 |
$10K |
| 0072A |
|
264 |
263 |
$10K |
| 0001A |
|
290 |
289 |
$10K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
300 |
291 |
$9K |
| 90671 |
|
185 |
173 |
$9K |
| 0004A |
|
245 |
243 |
$9K |
| 99173 |
|
10,175 |
10,077 |
$8K |
| 99441 |
|
1,282 |
1,184 |
$8K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,049 |
3,954 |
$6K |
| 97802 |
|
1,491 |
1,419 |
$6K |
| 90656 |
|
1,064 |
1,055 |
$6K |
| 99442 |
|
532 |
500 |
$5K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
479 |
452 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,232 |
1,223 |
$5K |
| 90670 |
|
951 |
932 |
$4K |
| 90480 |
|
156 |
154 |
$4K |
| 0134A |
|
122 |
120 |
$3K |
| 0124A |
|
112 |
107 |
$3K |
| 99215 |
Prolong outpt/office vis |
106 |
99 |
$3K |
| 0013A |
|
84 |
82 |
$3K |
| D1208 |
Topical application of fluoride, excluding varnish |
282 |
282 |
$3K |
| D1120 |
Prophylaxis - child |
200 |
200 |
$3K |
| 0031A |
|
68 |
68 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
698 |
682 |
$3K |
| 90697 |
|
256 |
255 |
$2K |
| 99384 |
|
111 |
111 |
$2K |
| 90750 |
|
12 |
12 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
78 |
67 |
$2K |
| 99383 |
|
168 |
168 |
$2K |
| 81025 |
|
767 |
749 |
$2K |
| 99382 |
|
43 |
43 |
$1K |
| D0603 |
|
136 |
136 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
14,031 |
8,725 |
$1K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
29 |
15 |
$1K |
| 90734 |
|
75 |
72 |
$972.22 |
| 59430 |
|
16 |
12 |
$914.12 |
| 90633 |
|
741 |
729 |
$745.85 |
| 99606 |
|
104 |
97 |
$740.22 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
27 |
27 |
$621.00 |
| 80305 |
|
108 |
96 |
$595.60 |
| 81002 |
|
3,687 |
2,620 |
$535.46 |
| 99174 |
|
84 |
83 |
$526.08 |
| 36415 |
Collection of venous blood by venipuncture |
1,250 |
1,176 |
$523.58 |
| D0220 |
Intraoral - periapical first radiographic image |
123 |
120 |
$461.25 |
| D1110 |
Prophylaxis - adult |
26 |
26 |
$442.00 |
| 11721 |
|
53 |
51 |
$434.64 |
| D1351 |
Sealant - per tooth |
39 |
13 |
$390.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
191 |
188 |
$371.40 |
| 99381 |
|
1,067 |
1,061 |
$342.24 |
| 90661 |
|
72 |
72 |
$321.23 |
| 99401 |
|
783 |
776 |
$303.86 |
| 96127 |
|
136 |
126 |
$260.25 |
| D0140 |
Limited oral evaluation - problem focused |
18 |
14 |
$252.00 |
| 85018 |
|
215 |
211 |
$241.05 |
| 90681 |
|
94 |
94 |
$240.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$234.05 |
| 90698 |
|
178 |
171 |
$213.68 |
| 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 |
784 |
685 |
$193.94 |
| 90723 |
|
12 |
12 |
$180.10 |
| D0230 |
Intraoral - periapical each additional radiographic image |
55 |
55 |
$167.75 |
| 93000 |
|
51 |
51 |
$165.77 |
| 90715 |
|
188 |
183 |
$143.49 |
| 92134 |
|
13 |
12 |
$143.12 |
| 99000 |
|
3,668 |
3,360 |
$127.88 |
| 81003 |
|
263 |
262 |
$121.05 |
| 99078 |
|
42 |
42 |
$112.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$88.40 |
| 92015 |
Determination of refractive state |
29 |
26 |
$86.40 |
| 99607 |
|
13 |
12 |
$72.20 |
| 3074F |
|
1,229 |
1,163 |
$63.75 |
| 92145 |
|
51 |
42 |
$55.81 |
| 91301 |
|
2,818 |
2,736 |
$16.94 |
| 87420 |
|
25 |
24 |
$6.96 |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,911 |
1,988 |
$0.00 |
| 91307 |
|
704 |
649 |
$0.00 |
| 3079F |
|
160 |
150 |
$0.00 |
| 86580 |
|
123 |
122 |
$0.00 |
| 90716 |
|
175 |
175 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
56 |
52 |
$0.00 |
| 91306 |
|
501 |
497 |
$0.00 |
| 91303 |
|
77 |
77 |
$0.00 |
| 36416 |
|
166 |
147 |
$0.00 |
| 90744 |
|
81 |
81 |
$0.00 |
| 0503F |
|
19 |
19 |
$0.00 |
| 90680 |
|
24 |
24 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
69 |
41 |
$0.00 |
| 96380 |
|
31 |
31 |
$0.00 |
| 92250 |
|
12 |
12 |
$0.00 |
| 90657 |
|
12 |
12 |
$0.00 |
| 3044F |
|
12 |
12 |
$0.00 |
| 4551F |
|
3,515 |
3,309 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
1,011 |
985 |
$0.00 |
| 3725F |
|
2,049 |
1,880 |
$0.00 |
| 0502F |
|
415 |
264 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
133 |
133 |
$0.00 |
| 3078F |
|
1,037 |
982 |
$0.00 |
| 91312 |
|
112 |
107 |
$0.00 |
| 99408 |
|
16 |
12 |
$0.00 |
| 99499 |
|
31 |
29 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
153 |
108 |
$0.00 |
| 91313 |
|
123 |
120 |
$0.00 |
| 90713 |
|
59 |
59 |
$0.00 |
| 91300 |
|
1,119 |
1,016 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |
| 3077F |
|
35 |
34 |
$0.00 |
| 91322 |
|
64 |
62 |
$0.00 |
| 90710 |
|
53 |
51 |
$0.00 |
| 91308 |
|
28 |
25 |
$0.00 |
| 90707 |
|
24 |
24 |
$0.00 |