| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
52,702 |
34,046 |
$2.84M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38,934 |
23,535 |
$686K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16,861 |
9,689 |
$457K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
8,512 |
6,093 |
$157K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,996 |
1,387 |
$63K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,877 |
1,346 |
$54K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,173 |
862 |
$36K |
| 90670 |
|
588 |
489 |
$35K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,795 |
1,773 |
$29K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
569 |
455 |
$23K |
| 81025 |
|
5,074 |
3,133 |
$16K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
2,106 |
1,079 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
463 |
340 |
$14K |
| 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 |
1,178 |
916 |
$12K |
| 90671 |
|
96 |
52 |
$12K |
| D7140 |
Extraction, erupted tooth or exposed root |
635 |
308 |
$12K |
| D0140 |
Limited oral evaluation - problem focused |
2,076 |
1,425 |
$12K |
| 87210 |
|
4,739 |
2,934 |
$10K |
| 90834 |
Psychotherapy, 45 minutes with patient |
474 |
219 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
946 |
661 |
$8K |
| 90715 |
|
381 |
331 |
$7K |
| 81002 |
|
5,555 |
3,418 |
$7K |
| D0330 |
Panoramic radiographic image |
611 |
411 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
212 |
121 |
$6K |
| 90633 |
|
220 |
198 |
$6K |
| 90651 |
|
614 |
510 |
$5K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
548 |
388 |
$4K |
| 90832 |
Psychotherapy, 30 minutes with patient |
215 |
100 |
$3K |
| 90648 |
|
259 |
220 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
388 |
276 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
407 |
185 |
$3K |
| D0274 |
Bitewings - four radiographic images |
618 |
419 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
1,701 |
1,133 |
$2K |
| 99078 |
|
63 |
25 |
$2K |
| 90672 |
|
97 |
90 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
345 |
234 |
$1K |
| D1110 |
Prophylaxis - adult |
96 |
62 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
354 |
233 |
$1K |
| 90636 |
|
12 |
12 |
$947.28 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,546 |
846 |
$548.23 |
| 86580 |
|
104 |
66 |
$352.40 |
| 90723 |
|
41 |
41 |
$270.00 |
| 90680 |
|
25 |
25 |
$250.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
27 |
13 |
$205.19 |
| 90716 |
|
15 |
15 |
$104.85 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
314 |
154 |
$52.47 |
| 82948 |
|
23 |
12 |
$49.14 |
| 90688 |
|
961 |
775 |
$3.79 |
| 90734 |
|
488 |
419 |
$2.11 |
| 90620 |
|
200 |
172 |
$1.17 |
| 3080F |
|
184 |
103 |
$0.57 |
| 3077F |
|
379 |
224 |
$0.57 |
| 90696 |
|
126 |
99 |
$0.56 |
| 90710 |
|
90 |
71 |
$0.55 |
| 3078F |
|
1,000 |
656 |
$0.41 |
| 3074F |
|
524 |
346 |
$0.34 |
| 90686 |
|
36 |
30 |
$0.21 |
| 90698 |
|
18 |
18 |
$0.18 |
| 3079F |
|
67 |
44 |
$0.07 |
| 90685 |
|
161 |
137 |
$0.05 |
| 1036F |
|
258 |
173 |
$0.00 |
| 1034F |
|
199 |
131 |
$0.00 |
| 1111F |
|
22 |
19 |
$0.00 |
| 90461 |
|
2,298 |
1,893 |
$0.00 |
| 90707 |
|
25 |
25 |
$0.00 |
| 4004F |
|
151 |
100 |
$0.00 |
| 99188 |
|
28 |
12 |
$0.00 |
| 0502F |
|
62 |
25 |
$0.00 |