| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
50,259 |
38,435 |
$11.72M |
| 00003 |
Internal/system code - not a standard HCPCS code |
9,944 |
8,760 |
$2.96M |
| 90834 |
Psychotherapy, 45 minutes with patient |
6,326 |
2,124 |
$229K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,326 |
842 |
$51K |
| 90837 |
Psychotherapy, 53 minutes with patient |
175 |
76 |
$14K |
| 90688 |
|
1,166 |
1,166 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24,157 |
20,875 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
65 |
51 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27,926 |
24,798 |
$3K |
| 99215 |
Prolong outpt/office vis |
5,140 |
3,770 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,141 |
7,039 |
$528.95 |
| 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 |
16 |
15 |
$488.67 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
633 |
517 |
$446.41 |
| 3008F |
|
19,786 |
19,099 |
$368.48 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
10,941 |
9,673 |
$329.33 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
333 |
331 |
$272.84 |
| 86704 |
|
174 |
174 |
$213.99 |
| 90734 |
|
56 |
56 |
$180.05 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
324 |
311 |
$174.87 |
| 3512F |
|
9,962 |
9,867 |
$164.92 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
870 |
860 |
$143.20 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,481 |
1,385 |
$132.31 |
| 90715 |
|
349 |
348 |
$126.94 |
| 90746 |
|
177 |
176 |
$116.20 |
| 82274 |
|
219 |
216 |
$112.22 |
| 90674 |
|
1,265 |
1,265 |
$90.00 |
| D0120 |
Periodic oral evaluation - established patient |
159 |
154 |
$68.00 |
| 80053 |
Comprehensive metabolic panel |
1,253 |
1,241 |
$63.30 |
| 90632 |
|
24 |
24 |
$46.58 |
| D0220 |
Intraoral - periapical first radiographic image |
184 |
158 |
$36.00 |
| 86803 |
|
391 |
390 |
$30.40 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
468 |
466 |
$22.16 |
| 99205 |
Prolong outpt/office vis |
40 |
40 |
$17.70 |
| 86708 |
|
214 |
213 |
$15.72 |
| 86317 |
|
106 |
105 |
$15.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
164 |
163 |
$6.00 |
| 82948 |
|
456 |
427 |
$2.68 |
| 3017F |
|
667 |
656 |
$0.00 |
| D1330 |
|
542 |
487 |
$0.00 |
| 87340 |
|
147 |
147 |
$0.00 |
| 99000 |
|
246 |
236 |
$0.00 |
| 99385 |
|
17 |
15 |
$0.00 |
| 90651 |
|
24 |
24 |
$0.00 |
| 99443 |
|
85 |
82 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
32 |
32 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
39 |
39 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
237 |
121 |
$0.00 |
| 99447 |
|
47 |
46 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
101 |
99 |
$0.00 |
| 99406 |
|
33 |
30 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
28 |
25 |
$0.00 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
13 |
13 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
35 |
35 |
$0.00 |
| D5899 |
|
72 |
58 |
$0.00 |
| 3011F |
|
12 |
12 |
$0.00 |
| 90739 |
|
26 |
25 |
$0.00 |
| 3044F |
|
13 |
13 |
$0.00 |
| 4293F |
|
14 |
14 |
$0.00 |
| D1110 |
Prophylaxis - adult |
172 |
165 |
$0.00 |
| D4341 |
|
269 |
129 |
$0.00 |
| 99401 |
|
375 |
361 |
$0.00 |
| 1160F |
|
798 |
703 |
$0.00 |
| 1159F |
|
801 |
706 |
$0.00 |
| 99408 |
|
110 |
109 |
$0.00 |
| 90661 |
|
340 |
340 |
$0.00 |
| 3725F |
|
356 |
349 |
$0.00 |
| 0124A |
|
37 |
37 |
$0.00 |
| 91312 |
|
37 |
37 |
$0.00 |
| 90750 |
|
43 |
43 |
$0.00 |
| D0270 |
|
18 |
15 |
$0.00 |
| J1380 |
Injection, estradiol valerate, up to 10 mg |
16 |
12 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
52 |
51 |
$0.00 |
| 3015F |
|
12 |
12 |
$0.00 |
| 81025 |
|
20 |
20 |
$0.00 |
| 3511F |
|
16 |
16 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
17 |
17 |
$0.00 |
| D4910 |
|
12 |
12 |
$0.00 |