| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
36,923 |
28,944 |
$5.31M |
| 00003 |
Internal/system code - not a standard HCPCS code |
2,417 |
1,957 |
$462K |
| 97810 |
|
12,397 |
6,761 |
$257K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,356 |
2,049 |
$28K |
| 97811 |
|
7,904 |
4,322 |
$27K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,706 |
1,105 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
34,084 |
21,785 |
$17K |
| 0003A |
|
301 |
169 |
$13K |
| 97026 |
|
2,136 |
1,413 |
$12K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,190 |
1,203 |
$9K |
| 0071A |
|
215 |
214 |
$9K |
| 0072A |
|
211 |
211 |
$8K |
| 97813 |
|
241 |
122 |
$6K |
| 0012A |
|
130 |
78 |
$4K |
| 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 |
798 |
683 |
$4K |
| 0002A |
|
63 |
34 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,487 |
1,141 |
$3K |
| 90688 |
|
508 |
400 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
667 |
599 |
$2K |
| 0064A |
|
56 |
54 |
$2K |
| 0001A |
|
42 |
23 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,706 |
1,771 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
498 |
401 |
$1K |
| 90750 |
|
38 |
24 |
$900.00 |
| D0210 |
Intraoral - complete series of radiographic images |
380 |
356 |
$746.00 |
| 98960 |
|
2,942 |
2,230 |
$662.39 |
| 0011A |
|
46 |
36 |
$658.88 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
139 |
137 |
$529.95 |
| D1120 |
Prophylaxis - child |
125 |
121 |
$468.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
257 |
184 |
$371.53 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
386 |
249 |
$356.96 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
832 |
612 |
$328.61 |
| D1206 |
Topical application of fluoride varnish |
115 |
115 |
$276.00 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
24 |
17 |
$260.40 |
| 3078F |
|
14,270 |
10,663 |
$249.41 |
| 90756 |
|
13 |
13 |
$210.00 |
| 90686 |
|
14 |
14 |
$210.00 |
| 3725F |
|
1,226 |
985 |
$165.22 |
| D9430 |
|
234 |
212 |
$148.00 |
| 3077F |
|
2,992 |
2,287 |
$131.77 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
2,536 |
1,915 |
$130.04 |
| 3075F |
|
3,674 |
2,865 |
$101.43 |
| D0220 |
Intraoral - periapical first radiographic image |
290 |
278 |
$91.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
34 |
26 |
$85.00 |
| 92015 |
Determination of refractive state |
438 |
399 |
$75.38 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,180 |
1,088 |
$58.57 |
| 99000 |
|
3,646 |
2,770 |
$57.52 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
20 |
14 |
$54.83 |
| D0230 |
Intraoral - periapical each additional radiographic image |
568 |
179 |
$47.85 |
| D1351 |
Sealant - per tooth |
130 |
63 |
$46.50 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
179 |
173 |
$39.05 |
| 92002 |
|
20 |
15 |
$32.47 |
| 90656 |
|
132 |
132 |
$24.23 |
| 1125F |
|
2,420 |
1,600 |
$23.76 |
| D4910 |
|
151 |
151 |
$22.00 |
| 82274 |
|
16 |
16 |
$14.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
70 |
41 |
$5.40 |
| 86689 |
|
163 |
97 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
189 |
135 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
32 |
32 |
$0.00 |
| 2022F |
|
313 |
229 |
$0.00 |
| D9110 |
|
26 |
24 |
$0.00 |
| D1110 |
Prophylaxis - adult |
33 |
33 |
$0.00 |
| 82570 |
|
71 |
35 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
31 |
29 |
$0.00 |
| 3342F |
|
151 |
144 |
$0.00 |
| G2196 |
Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
76 |
76 |
$0.00 |
| D4341 |
|
167 |
64 |
$0.00 |
| 80061 |
Lipid panel |
350 |
207 |
$0.00 |
| 4004F |
|
41 |
26 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
38 |
25 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15 |
15 |
$0.00 |
| 03 |
Instill, bupivac and meloxic |
40 |
38 |
$0.00 |
| 3080F |
|
1,419 |
1,066 |
$0.00 |
| 3008F |
|
18,898 |
13,695 |
$0.00 |
| 99386 |
|
18 |
14 |
$0.00 |
| 3074F |
|
13,651 |
10,140 |
$0.00 |
| 3079F |
|
4,547 |
3,485 |
$0.00 |
| D1330 |
|
320 |
312 |
$0.00 |
| 1126F |
|
6,520 |
4,419 |
$0.00 |
| 1034F |
|
62 |
40 |
$0.00 |
| 97814 |
|
211 |
109 |
$0.00 |
| 1123F |
|
113 |
109 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
82 |
54 |
$0.00 |
| D0171 |
|
86 |
66 |
$0.00 |
| 98961 |
|
61 |
49 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
341 |
198 |
$0.00 |
| 97014 |
|
185 |
123 |
$0.00 |
| 97535 |
Self-care/home management training, each 15 minutes |
79 |
62 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
57 |
52 |
$0.00 |
| 99406 |
|
37 |
26 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
15 |
15 |
$0.00 |
| 82043 |
|
71 |
35 |
$0.00 |
| 91301 |
|
32 |
32 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
18 |
12 |
$0.00 |
| 92230 |
|
20 |
20 |
$0.00 |
| 1000F |
|
18 |
13 |
$0.00 |
| 4000F |
|
41 |
26 |
$0.00 |