| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
33,645 |
30,579 |
$5.17M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31,724 |
28,567 |
$158K |
| 90686 |
|
4,694 |
4,670 |
$43K |
| D1206 |
Topical application of fluoride varnish |
2,042 |
1,951 |
$35K |
| 90670 |
|
1,725 |
1,701 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
257 |
251 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,337 |
1,286 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,389 |
5,203 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,126 |
2,992 |
$11K |
| G9920 |
Screening performed and negative |
376 |
376 |
$11K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,070 |
1,441 |
$10K |
| 90647 |
|
1,061 |
1,018 |
$9K |
| 90723 |
|
1,016 |
1,009 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,408 |
2,317 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,262 |
1,204 |
$8K |
| 90633 |
|
886 |
877 |
$8K |
| 90680 |
|
720 |
713 |
$6K |
| 90649 |
|
743 |
713 |
$6K |
| 00003 |
Internal/system code - not a standard HCPCS code |
25 |
25 |
$5K |
| 92551 |
|
5,488 |
5,296 |
$5K |
| 90734 |
|
491 |
472 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
882 |
819 |
$4K |
| 90715 |
|
321 |
305 |
$3K |
| 99215 |
Prolong outpt/office vis |
114 |
78 |
$3K |
| 90710 |
|
228 |
228 |
$2K |
| 90696 |
|
207 |
207 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
133 |
127 |
$2K |
| 90700 |
|
194 |
187 |
$2K |
| 90716 |
|
174 |
168 |
$2K |
| 90707 |
|
159 |
153 |
$1K |
| 90620 |
|
30 |
30 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
28 |
25 |
$528.22 |
| 90674 |
|
31 |
31 |
$279.00 |
| A4267 |
Contraceptive supply, condom, male, each |
14 |
14 |
$119.08 |
| 90651 |
|
13 |
13 |
$117.00 |
| 90685 |
|
12 |
12 |
$108.00 |
| 81025 |
|
26 |
26 |
$72.80 |
| 92081 |
|
178 |
178 |
$32.95 |
| S5199 |
Personal care item, nos, each |
14 |
14 |
$11.58 |
| 81005 |
|
31 |
30 |
$2.84 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
49 |
47 |
$2.01 |
| 90832 |
Psychotherapy, 30 minutes with patient |
974 |
560 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
66 |
66 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
54 |
41 |
$0.00 |