| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,658,032 |
1,125,324 |
$345.37M |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
4,313 |
4,270 |
$3.77M |
| 99238 |
Hospital discharge day management, 30 minutes or less |
16,374 |
16,264 |
$989K |
| 99460 |
|
7,771 |
7,733 |
$517K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,822 |
3,648 |
$276K |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
6,543 |
5,891 |
$207K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
2,913 |
2,011 |
$136K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
2,138 |
1,473 |
$128K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
1,272 |
1,250 |
$126K |
| 59025 |
Fetal non-stress test |
10,472 |
6,137 |
$100K |
| 76801 |
|
1,029 |
968 |
$63K |
| 59514 |
|
63 |
62 |
$59K |
| 76818 |
|
696 |
473 |
$52K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
499,603 |
406,039 |
$51K |
| 76813 |
|
501 |
491 |
$32K |
| 99221 |
|
294 |
289 |
$25K |
| 99462 |
|
861 |
580 |
$25K |
| 99463 |
|
322 |
322 |
$24K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
292 |
241 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
136,719 |
120,102 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
43,912 |
37,823 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
56,172 |
46,266 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
181,578 |
160,325 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
62,248 |
53,453 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
54,702 |
47,108 |
$10K |
| 99234 |
|
81 |
79 |
$9K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
135 |
116 |
$9K |
| 99233 |
Prolong inpt eval add15 m |
100 |
71 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
79 |
79 |
$8K |
| 90461 |
|
89,359 |
78,845 |
$7K |
| 99442 |
|
121,224 |
100,974 |
$5K |
| 76821 |
|
107 |
65 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
57,038 |
47,941 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
85,873 |
72,279 |
$3K |
| 0001A |
|
7,897 |
7,630 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
17,207 |
15,538 |
$2K |
| 96156 |
|
46,968 |
41,553 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12,404 |
11,257 |
$2K |
| 97803 |
|
73,214 |
59,006 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
11,230 |
10,249 |
$2K |
| 97804 |
|
1,169 |
643 |
$2K |
| 97802 |
|
70,671 |
62,406 |
$2K |
| 76820 |
|
106 |
66 |
$2K |
| 0002A |
|
5,527 |
5,484 |
$1K |
| 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 |
29,867 |
24,645 |
$1K |
| 99384 |
|
3,608 |
3,112 |
$1K |
| 99381 |
|
5,730 |
4,892 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
33,920 |
30,034 |
$1K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
105 |
86 |
$1K |
| 96152 |
|
27,974 |
22,341 |
$1K |
| 99441 |
|
8,473 |
7,939 |
$1K |
| 99383 |
|
5,046 |
4,398 |
$972.82 |
| 0012A |
|
2,913 |
2,878 |
$920.00 |
| 0071A |
|
3,596 |
3,286 |
$901.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
6,440 |
5,906 |
$805.28 |
| 81025 |
|
27,884 |
24,949 |
$704.56 |
| 99443 |
|
5,713 |
5,271 |
$699.16 |
| 0011A |
|
3,321 |
3,271 |
$673.91 |
| D0190 |
|
13,019 |
11,830 |
$603.98 |
| 0003A |
|
626 |
608 |
$440.00 |
| 99177 |
|
36,188 |
32,427 |
$438.27 |
| 0072A |
|
2,634 |
2,561 |
$403.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
19,476 |
17,364 |
$381.84 |
| 90715 |
|
11,862 |
10,381 |
$321.79 |
| 99385 |
|
3,448 |
3,124 |
$313.24 |
| 86328 |
|
7,421 |
6,898 |
$294.01 |
| 90688 |
|
29,544 |
25,940 |
$291.23 |
| 0064A |
|
1,830 |
1,784 |
$283.34 |
| 0013A |
|
186 |
184 |
$280.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
8,275 |
7,729 |
$268.16 |
| 92558 |
|
39,707 |
35,048 |
$259.73 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,320 |
2,931 |
$245.17 |
| 90686 |
|
35,313 |
30,546 |
$237.85 |
| 96154 |
|
20,542 |
17,392 |
$234.13 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16,809 |
15,216 |
$228.34 |
| 92552 |
|
35,960 |
33,976 |
$224.01 |
| 81003 |
|
66,906 |
48,652 |
$217.90 |
| 96153 |
|
1,067 |
604 |
$200.56 |
| 99422 |
|
13,304 |
12,504 |
$146.24 |
| 90651 |
|
18,700 |
16,179 |
$142.13 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
10,584 |
9,720 |
$122.69 |
| 0031A |
|
262 |
260 |
$120.00 |
| 99173 |
|
70,771 |
65,405 |
$115.38 |
| 82962 |
|
57,751 |
45,865 |
$113.66 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
5,027 |
4,435 |
$112.25 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
20,726 |
18,100 |
$86.24 |
| 58300 |
|
112 |
103 |
$64.73 |
| 90480 |
|
2,209 |
2,045 |
$40.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
13,861 |
10,287 |
$34.14 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
2,315 |
1,935 |
$33.58 |
| 90680 |
|
21,420 |
18,818 |
$16.09 |
| 90633 |
|
19,399 |
17,027 |
$5.92 |
| 81002 |
|
2,457 |
1,591 |
$3.20 |
| 69209 |
|
1,534 |
1,377 |
$2.65 |
| 96160 |
|
2,679 |
2,346 |
$2.63 |
| 96164 |
|
48 |
30 |
$1.98 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
2,152 |
1,846 |
$0.17 |
| 90698 |
|
15,628 |
13,726 |
$0.14 |
| 90670 |
|
34,815 |
30,523 |
$0.07 |
| 90710 |
|
17,263 |
14,795 |
$0.07 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
137 |
122 |
$0.04 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
11,897 |
10,908 |
$0.00 |
| D0603 |
|
9,625 |
6,799 |
$0.00 |
| 1111F |
|
413 |
409 |
$0.00 |
| 90696 |
|
7,925 |
6,575 |
$0.00 |
| 90723 |
|
9,176 |
8,166 |
$0.00 |
| 3075F |
|
3,987 |
3,882 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
19,848 |
9,413 |
$0.00 |
| 90744 |
|
6,469 |
5,673 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
3,395 |
3,033 |
$0.00 |
| 91301 |
|
4,836 |
4,081 |
$0.00 |
| 96161 |
|
5,022 |
4,397 |
$0.00 |
| D1351 |
Sealant - per tooth |
6,281 |
1,773 |
$0.00 |
| 91306 |
|
746 |
727 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
27,266 |
20,370 |
$0.00 |
| 86580 |
|
711 |
611 |
$0.00 |
| D0602 |
|
7,463 |
5,351 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
17,893 |
12,944 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,678 |
4,269 |
$0.00 |
| 90697 |
|
4,239 |
3,714 |
$0.00 |
| 3080F |
|
1,408 |
1,348 |
$0.00 |
| 3074F |
|
30,583 |
27,818 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
1,574 |
1,353 |
$0.00 |
| 90619 |
|
2,419 |
2,177 |
$0.00 |
| N4143 |
|
181 |
181 |
$0.00 |
| 91307 |
|
1,881 |
1,749 |
$0.00 |
| 85018 |
|
4,955 |
4,210 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
3,423 |
2,847 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
4,824 |
3,061 |
$0.00 |
| D0601 |
|
5,491 |
3,829 |
$0.00 |
| 90677 |
|
2,494 |
2,273 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,073 |
1,554 |
$0.00 |
| 99386 |
|
349 |
314 |
$0.00 |
| 91305 |
|
211 |
201 |
$0.00 |
| D0240 |
|
11,974 |
3,648 |
$0.00 |
| 96127 |
|
2,549 |
2,546 |
$0.00 |
| 1125F |
|
1,430 |
1,367 |
$0.00 |
| 3008F |
|
38,024 |
34,707 |
$0.00 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
1,621 |
1,520 |
$0.00 |
| D1330 |
|
11,908 |
10,924 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
997 |
763 |
$0.00 |
| 90656 |
|
3,157 |
2,686 |
$0.00 |
| D0604 |
|
81 |
77 |
$0.00 |
| 3079F |
|
8,322 |
7,868 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
318 |
198 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
42 |
42 |
$0.00 |
| 90732 |
|
468 |
395 |
$0.00 |
| G9754 |
A finding of an incidental pulmonary nodule |
28 |
26 |
$0.00 |
| 1126F |
|
2,195 |
2,119 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
137 |
117 |
$0.00 |
| 90716 |
|
236 |
210 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
30 |
25 |
$0.00 |
| 0081A |
|
94 |
80 |
$0.00 |
| 91303 |
|
171 |
142 |
$0.00 |
| 91319 |
|
81 |
69 |
$0.00 |
| 96170 |
|
454 |
433 |
$0.00 |
| 0154A |
|
255 |
252 |
$0.00 |
| 0051A |
|
124 |
96 |
$0.00 |
| 58301 |
|
12 |
12 |
$0.00 |
| 90674 |
|
31 |
24 |
$0.00 |
| 0173A |
|
61 |
56 |
$0.00 |
| J3490 |
Unclassified drugs |
57 |
43 |
$0.00 |
| 91315 |
|
62 |
59 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
57 |
53 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
96 |
68 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
124 |
112 |
$0.00 |
| 3044F |
|
14 |
14 |
$0.00 |
| 91318 |
|
82 |
74 |
$0.00 |
| 94760 |
|
31 |
29 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$0.00 |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
13 |
13 |
$0.00 |
| 90620 |
|
12 |
12 |
$0.00 |
| 90700 |
|
3,184 |
2,852 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
9,739 |
6,974 |
$0.00 |
| D1110 |
Prophylaxis - adult |
2,729 |
2,096 |
$0.00 |
| D0330 |
Panoramic radiographic image |
3,808 |
2,867 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
14,916 |
10,944 |
$0.00 |
| 3078F |
|
27,174 |
24,954 |
$0.00 |
| 80305 |
|
148 |
83 |
$0.00 |
| 91300 |
|
10,019 |
7,547 |
$0.00 |
| 90648 |
|
13,092 |
11,633 |
$0.00 |
| 99421 |
|
1,129 |
1,103 |
$0.00 |
| D0270 |
|
480 |
396 |
$0.00 |
| 90734 |
|
10,537 |
8,917 |
$0.00 |
| 3077F |
|
2,504 |
2,368 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
3,696 |
2,780 |
$0.00 |
| 99382 |
|
1,911 |
1,662 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,836 |
3,465 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,468 |
1,581 |
$0.00 |
| 96167 |
|
1,374 |
1,234 |
$0.00 |
| 91320 |
|
1,891 |
1,688 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
597 |
512 |
$0.00 |
| D1120 |
Prophylaxis - child |
22,541 |
16,545 |
$0.00 |
| 99423 |
|
505 |
486 |
$0.00 |
| 90750 |
|
290 |
282 |
$0.00 |
| 90746 |
|
1,210 |
1,037 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
1,066 |
683 |
$0.00 |
| 96158 |
|
1,299 |
1,202 |
$0.00 |
| 91312 |
|
1,156 |
1,141 |
$0.00 |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
158 |
141 |
$0.00 |
| 90685 |
|
8,089 |
7,110 |
$0.00 |
| 85610 |
|
103 |
67 |
$0.00 |
| 99201 |
|
219 |
204 |
$0.00 |
| 90681 |
|
1,457 |
1,317 |
$0.00 |
| D0191 |
|
136 |
136 |
$0.00 |
| N4142 |
|
178 |
178 |
$0.00 |
| 3725F |
|
5,935 |
5,764 |
$0.00 |
| 0124A |
|
2,152 |
2,082 |
$0.00 |
| 90707 |
|
161 |
138 |
$0.00 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
1,864 |
1,670 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
234 |
206 |
$0.00 |
| D1354 |
|
255 |
70 |
$0.00 |
| 11981 |
|
211 |
187 |
$0.00 |
| 0054A |
|
25 |
24 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
104 |
79 |
$0.00 |
| 0053A |
|
424 |
354 |
$0.00 |
| 91308 |
|
30 |
25 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
41 |
36 |
$0.00 |
| N4141 |
|
166 |
166 |
$0.00 |
| 0073A |
|
109 |
104 |
$0.00 |
| 69210 |
|
31 |
28 |
$0.00 |
| 90713 |
|
16 |
14 |
$0.00 |
| 99397 |
|
54 |
53 |
$0.00 |