| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
575,187 |
407,796 |
$80.12M |
| D0999 |
Unspecified diagnostic procedure, by report |
14,956 |
12,283 |
$1.46M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
251,890 |
197,492 |
$480K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
60,094 |
50,031 |
$182K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26,593 |
21,528 |
$77K |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
987 |
822 |
$67K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
18,230 |
15,705 |
$67K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
19,504 |
17,400 |
$61K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12,253 |
10,802 |
$43K |
| 0502F |
|
20,054 |
12,833 |
$42K |
| 0012A |
|
995 |
989 |
$40K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12,810 |
11,566 |
$38K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
20,971 |
16,595 |
$38K |
| 0011A |
|
1,071 |
1,053 |
$37K |
| 99385 |
|
5,392 |
4,466 |
$27K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
28 |
24 |
$24K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
9,853 |
8,454 |
$23K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
6,381 |
5,299 |
$21K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
30,678 |
23,497 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26,278 |
21,666 |
$17K |
| 90832 |
Psychotherapy, 30 minutes with patient |
22,679 |
13,862 |
$17K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,627 |
1,146 |
$16K |
| 90791 |
Psychiatric diagnostic evaluation |
1,846 |
1,667 |
$15K |
| 99386 |
|
3,664 |
3,122 |
$15K |
| 90670 |
|
18,375 |
14,337 |
$13K |
| 81025 |
|
54,169 |
44,877 |
$12K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13,062 |
11,169 |
$12K |
| 90837 |
Psychotherapy, 53 minutes with patient |
3,856 |
2,497 |
$12K |
| 99383 |
|
2,797 |
2,391 |
$11K |
| 99381 |
|
5,148 |
4,463 |
$11K |
| 0001A |
|
257 |
256 |
$11K |
| 0500F |
|
3,836 |
3,533 |
$11K |
| 99382 |
|
2,266 |
1,758 |
$9K |
| 90633 |
|
13,418 |
10,654 |
$8K |
| 99384 |
|
1,839 |
1,627 |
$8K |
| 90649 |
|
9,239 |
8,071 |
$8K |
| 0002A |
|
177 |
177 |
$7K |
| 90698 |
|
12,130 |
9,501 |
$7K |
| 96160 |
|
35,176 |
25,478 |
$7K |
| 90715 |
|
8,542 |
7,414 |
$6K |
| 81002 |
|
55,525 |
40,045 |
$6K |
| 0004A |
|
127 |
115 |
$5K |
| 90710 |
|
7,257 |
6,080 |
$5K |
| 99000 |
|
6,777 |
4,979 |
$5K |
| 90658 |
|
9,570 |
8,154 |
$4K |
| 90733 |
|
5,623 |
4,860 |
$4K |
| 90681 |
|
7,775 |
6,177 |
$4K |
| 90707 |
|
5,817 |
4,453 |
$4K |
| 90716 |
|
5,631 |
4,320 |
$4K |
| 90686 |
|
4,262 |
3,864 |
$4K |
| 90696 |
|
5,232 |
4,456 |
$4K |
| 0503F |
|
1,272 |
1,153 |
$4K |
| 90744 |
|
7,546 |
5,937 |
$3K |
| 90734 |
|
2,393 |
2,273 |
$3K |
| 90700 |
|
4,156 |
3,427 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
20,439 |
11,502 |
$2K |
| 90620 |
|
1,779 |
1,658 |
$2K |
| 0124A |
|
53 |
51 |
$2K |
| 90723 |
|
4,348 |
3,295 |
$2K |
| 90648 |
|
3,215 |
2,648 |
$2K |
| 57454 |
|
616 |
540 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,533 |
3,968 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,140 |
850 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,483 |
4,168 |
$1K |
| 90647 |
|
3,000 |
2,282 |
$1K |
| 90657 |
|
3,611 |
2,556 |
$1K |
| 0064A |
|
28 |
28 |
$1K |
| D1120 |
Prophylaxis - child |
4,407 |
4,032 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
2,026 |
1,900 |
$1K |
| 11976 |
|
270 |
210 |
$1K |
| 90713 |
|
784 |
698 |
$1K |
| 99401 |
|
4,071 |
2,884 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,803 |
3,309 |
$1K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
954 |
717 |
$987.20 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16,722 |
12,667 |
$941.75 |
| 90834 |
Psychotherapy, 45 minutes with patient |
444 |
363 |
$910.72 |
| D7140 |
Extraction, erupted tooth or exposed root |
220 |
162 |
$899.76 |
| 90651 |
|
576 |
552 |
$877.99 |
| 99397 |
|
172 |
163 |
$770.20 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
36,679 |
20,798 |
$714.00 |
| 59430 |
|
134 |
127 |
$651.52 |
| D1208 |
Topical application of fluoride, excluding varnish |
3,965 |
3,626 |
$650.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
8,423 |
5,767 |
$642.25 |
| 92551 |
|
2,333 |
1,841 |
$622.79 |
| D0140 |
Limited oral evaluation - problem focused |
1,448 |
1,325 |
$567.00 |
| 58300 |
|
273 |
218 |
$549.73 |
| 82948 |
|
3,529 |
2,951 |
$496.26 |
| D1110 |
Prophylaxis - adult |
1,238 |
1,177 |
$451.00 |
| 93000 |
|
620 |
503 |
$391.55 |
| 90732 |
|
152 |
130 |
$365.76 |
| D0120 |
Periodic oral evaluation - established patient |
3,163 |
2,929 |
$336.00 |
| 58301 |
|
217 |
156 |
$325.68 |
| 90746 |
|
73 |
67 |
$310.00 |
| D0220 |
Intraoral - periapical first radiographic image |
4,566 |
4,163 |
$268.80 |
| 90461 |
|
13,649 |
10,848 |
$262.00 |
| 90680 |
|
593 |
437 |
$250.32 |
| 69210 |
|
427 |
337 |
$235.40 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
186 |
152 |
$235.20 |
| 58100 |
|
143 |
120 |
$220.60 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
32 |
29 |
$153.93 |
| D0274 |
Bitewings - four radiographic images |
2,145 |
1,986 |
$84.50 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
957 |
692 |
$72.50 |
| J0456 |
Injection, azithromycin, 500 mg |
1,133 |
860 |
$56.85 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
827 |
671 |
$56.27 |
| 11981 |
|
62 |
37 |
$45.00 |
| 87501 |
|
5,202 |
4,655 |
$43.34 |
| G0008 |
Administration of influenza virus vaccine |
3,728 |
3,020 |
$34.05 |
| 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 |
1,099 |
876 |
$33.99 |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,365 |
3,025 |
$22.80 |
| D0272 |
Bitewings - two radiographic images |
792 |
693 |
$18.80 |
| D0270 |
|
108 |
108 |
$11.20 |
| 97802 |
|
232 |
178 |
$10.00 |
| 86580 |
|
864 |
620 |
$8.00 |
| 90685 |
|
1,002 |
764 |
$6.00 |
| D0603 |
|
2,604 |
2,376 |
$0.00 |
| 90697 |
|
837 |
793 |
$0.00 |
| 87081 |
|
90 |
83 |
$0.00 |
| D1351 |
Sealant - per tooth |
582 |
268 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
4,567 |
4,092 |
$0.00 |
| 94760 |
|
88 |
56 |
$0.00 |
| 90656 |
|
73 |
71 |
$0.00 |
| 90677 |
|
1,047 |
944 |
$0.00 |
| D0601 |
|
32 |
32 |
$0.00 |
| D0602 |
|
24 |
24 |
$0.00 |
| 99172 |
|
302 |
170 |
$0.00 |
| 90381 |
|
12 |
12 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
12 |
12 |
$0.00 |
| 88720 |
|
17 |
16 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
530 |
426 |
$0.00 |
| 90668 |
|
327 |
311 |
$0.00 |
| 91312 |
|
26 |
25 |
$0.00 |
| 97803 |
|
200 |
177 |
$0.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
63 |
63 |
$0.00 |
| D4341 |
|
371 |
269 |
$0.00 |
| 59025 |
Fetal non-stress test |
55 |
43 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
180 |
151 |
$0.00 |
| 99408 |
|
232 |
168 |
$0.00 |
| 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 |
21 |
17 |
$0.00 |
| 90662 |
|
18 |
16 |
$0.00 |