| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
126,477 |
108,107 |
$24.99M |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,049 |
1,555 |
$147K |
| 99499 |
|
2,841 |
2,607 |
$31K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
740 |
639 |
$25K |
| 0012A |
|
430 |
426 |
$15K |
| 0011A |
|
418 |
416 |
$14K |
| 0002A |
|
343 |
337 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
23,557 |
21,089 |
$10K |
| 90791 |
Psychiatric diagnostic evaluation |
116 |
102 |
$9K |
| 90832 |
Psychotherapy, 30 minutes with patient |
857 |
591 |
$9K |
| 0001A |
|
233 |
231 |
$8K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
431 |
385 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13,529 |
12,143 |
$5K |
| 0064A |
|
123 |
123 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,536 |
16,150 |
$5K |
| 3079F |
|
1,130 |
1,101 |
$4K |
| 87428 |
|
95 |
94 |
$4K |
| 3725F |
|
1,604 |
1,559 |
$4K |
| 90834 |
Psychotherapy, 45 minutes with patient |
66 |
51 |
$3K |
| 3077F |
|
1,010 |
967 |
$3K |
| 96127 |
|
71 |
71 |
$3K |
| 3074F |
|
837 |
816 |
$3K |
| 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 |
247 |
229 |
$3K |
| 3078F |
|
629 |
616 |
$2K |
| 0004A |
|
57 |
57 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
8,376 |
4,760 |
$2K |
| 3075F |
|
540 |
532 |
$2K |
| 90480 |
|
110 |
109 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,289 |
1,168 |
$1K |
| 0071A |
|
34 |
34 |
$1K |
| 90461 |
|
2,058 |
1,660 |
$1K |
| 3080F |
|
629 |
598 |
$905.10 |
| 0502F |
|
278 |
217 |
$733.20 |
| 0072A |
|
15 |
15 |
$560.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,725 |
1,608 |
$556.93 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
965 |
879 |
$450.00 |
| 92551 |
|
4,477 |
4,162 |
$309.34 |
| 99173 |
|
4,280 |
3,985 |
$238.05 |
| 90686 |
|
1,502 |
1,429 |
$221.95 |
| 11721 |
|
385 |
381 |
$150.00 |
| 81000 |
|
647 |
528 |
$86.40 |
| 80061 |
Lipid panel |
1,764 |
1,606 |
$60.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
508 |
470 |
$29.70 |
| 81025 |
|
2,658 |
2,512 |
$24.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
181 |
168 |
$20.97 |
| 91321 |
|
12 |
12 |
$20.00 |
| 3051F |
|
15 |
14 |
$20.00 |
| 90723 |
|
257 |
244 |
$10.00 |
| S9470 |
Nutritional counseling, dietitian visit |
1,719 |
1,555 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
798 |
760 |
$0.00 |
| 90734 |
|
440 |
429 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
1,079 |
1,056 |
$0.00 |
| 90670 |
|
102 |
101 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
49 |
44 |
$0.00 |
| 90648 |
|
108 |
107 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
517 |
495 |
$0.00 |
| D9110 |
|
47 |
47 |
$0.00 |
| D1120 |
Prophylaxis - child |
408 |
405 |
$0.00 |
| 90710 |
|
45 |
45 |
$0.00 |
| D0330 |
Panoramic radiographic image |
147 |
147 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
25 |
25 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
666 |
654 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
229 |
209 |
$0.00 |
| 4004F |
|
63 |
62 |
$0.00 |
| 90633 |
|
191 |
188 |
$0.00 |
| D1110 |
Prophylaxis - adult |
395 |
395 |
$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 |
237 |
230 |
$0.00 |
| 90715 |
|
105 |
97 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
135 |
120 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
145 |
100 |
$0.00 |
| 91322 |
|
113 |
113 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
71 |
69 |
$0.00 |
| G0124 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician |
12 |
12 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
30 |
25 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
594 |
590 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
1,307 |
1,284 |
$0.00 |
| 90620 |
|
162 |
153 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
362 |
361 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
145 |
142 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,036 |
850 |
$0.00 |
| D1330 |
|
1,776 |
1,718 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
285 |
231 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
100 |
97 |
$0.00 |
| D1310 |
|
1,296 |
1,256 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
467 |
456 |
$0.00 |
| 90651 |
|
448 |
437 |
$0.00 |
| D0601 |
|
490 |
476 |
$0.00 |
| 1031F |
|
72 |
71 |
$0.00 |
| D0603 |
|
505 |
496 |
$0.00 |
| 90656 |
|
149 |
149 |
$0.00 |
| 88142 |
|
141 |
136 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
163 |
162 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
112 |
111 |
$0.00 |
| 91301 |
|
77 |
76 |
$0.00 |
| 1036F |
|
34 |
34 |
$0.00 |
| D0602 |
|
98 |
98 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| D5899 |
|
12 |
12 |
$0.00 |
| 87807 |
|
13 |
13 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14 |
13 |
$0.00 |