| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,306,970 |
937,694 |
$336.74M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
514,954 |
419,830 |
$20.78M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
91,519 |
88,531 |
$9.11M |
| 99381 |
|
29,723 |
28,887 |
$6.39M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
114,153 |
105,650 |
$6.26M |
| 90834 |
Psychotherapy, 45 minutes with patient |
121,452 |
75,143 |
$5.76M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
75,453 |
73,838 |
$3.94M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
86,347 |
77,072 |
$3.35M |
| 90832 |
Psychotherapy, 30 minutes with patient |
74,031 |
45,698 |
$2.76M |
| D0999 |
Unspecified diagnostic procedure, by report |
9,713 |
8,700 |
$2.24M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
36,912 |
35,982 |
$1.89M |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
20,773 |
20,130 |
$1.15M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
17,764 |
17,006 |
$571K |
| 90791 |
Psychiatric diagnostic evaluation |
9,834 |
9,379 |
$536K |
| G9012 |
Other specified case management service not elsewhere classified |
3,889 |
3,002 |
$533K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
940 |
834 |
$528K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
11,811 |
5,491 |
$499K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
5,062 |
4,862 |
$448K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
10,626 |
10,088 |
$385K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
6,880 |
6,700 |
$379K |
| 99383 |
|
4,262 |
4,053 |
$376K |
| 99382 |
|
2,733 |
2,587 |
$280K |
| 99384 |
|
3,541 |
3,319 |
$263K |
| 59430 |
|
8,380 |
7,659 |
$259K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
5,876 |
5,626 |
$175K |
| 99385 |
|
1,093 |
1,046 |
$129K |
| 99215 |
Prolong outpt/office vis |
1,798 |
1,684 |
$124K |
| 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 |
2,612 |
2,368 |
$99K |
| 97169 |
|
5,121 |
4,976 |
$87K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
656 |
626 |
$85K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,151 |
962 |
$71K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,239 |
1,149 |
$39K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
885 |
633 |
$34K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
172,770 |
167,010 |
$20K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,398 |
1,284 |
$20K |
| 99205 |
Prolong outpt/office vis |
303 |
301 |
$15K |
| 99050 |
|
3,465 |
3,372 |
$14K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
122 |
100 |
$13K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
681 |
570 |
$12K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
386 |
230 |
$12K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
344 |
325 |
$9K |
| V2025 |
Deluxe frame |
410 |
361 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
113,320 |
100,620 |
$9K |
| 76801 |
|
12,245 |
11,390 |
$8K |
| 90686 |
|
50,627 |
49,072 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
31,645 |
30,058 |
$8K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
12 |
12 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
25,752 |
24,594 |
$5K |
| V2020 |
Frames, purchases |
550 |
514 |
$5K |
| 91322 |
|
787 |
759 |
$4K |
| 81025 |
|
21,172 |
19,639 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
468 |
424 |
$4K |
| 90715 |
|
20,250 |
19,419 |
$4K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
5,202 |
4,617 |
$3K |
| 90621 |
|
3,025 |
2,912 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
5,066 |
4,771 |
$3K |
| 99401 |
|
26,980 |
26,159 |
$2K |
| 90480 |
|
1,134 |
1,094 |
$2K |
| 87428 |
|
57 |
55 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,086 |
2,031 |
$2K |
| 11981 |
|
1,032 |
893 |
$2K |
| 90670 |
|
43,537 |
42,727 |
$2K |
| 90723 |
|
52,202 |
50,838 |
$2K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
12,756 |
12,313 |
$2K |
| 99386 |
|
16 |
13 |
$2K |
| 90648 |
|
65,218 |
63,600 |
$2K |
| 3044F |
|
11,846 |
9,997 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,539 |
2,282 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,727 |
6,109 |
$1K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
4,446 |
4,234 |
$1K |
| 85018 |
|
14,566 |
14,170 |
$1K |
| 90633 |
|
25,696 |
25,064 |
$1K |
| 90710 |
|
7,808 |
7,541 |
$1K |
| 90681 |
|
32,086 |
31,159 |
$886.29 |
| 92551 |
|
12,970 |
12,651 |
$872.07 |
| 87807 |
|
2,973 |
2,887 |
$865.04 |
| A9150 |
Non-prescription drugs |
3,825 |
3,426 |
$864.51 |
| 99000 |
|
3,531 |
3,337 |
$846.69 |
| 90700 |
|
10,658 |
10,427 |
$762.28 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,379 |
1,350 |
$722.71 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15 |
15 |
$721.36 |
| 3046F |
|
483 |
433 |
$660.00 |
| 90651 |
|
15,598 |
14,967 |
$562.65 |
| V2750 |
Anti-reflective coating, per lens |
12 |
12 |
$530.99 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,647 |
3,599 |
$469.86 |
| 81002 |
|
5,856 |
5,534 |
$446.77 |
| D0145 |
Oral evaluation for a patient under three years of age |
2,519 |
2,475 |
$436.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,085 |
1,028 |
$424.82 |
| 58300 |
|
288 |
246 |
$417.08 |
| 90734 |
|
9,160 |
8,858 |
$404.35 |
| 81003 |
|
5,392 |
5,012 |
$391.20 |
| 83026 |
|
8,545 |
8,249 |
$388.45 |
| 90716 |
|
12,468 |
12,178 |
$368.55 |
| 3051F |
|
148 |
134 |
$360.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
11,400 |
7,873 |
$349.63 |
| D0220 |
Intraoral - periapical first radiographic image |
1,480 |
1,438 |
$335.18 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
496 |
392 |
$302.39 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,423 |
1,383 |
$266.08 |
| 90696 |
|
7,255 |
6,997 |
$254.19 |
| D0274 |
Bitewings - four radiographic images |
317 |
310 |
$236.66 |
| D0120 |
Periodic oral evaluation - established patient |
727 |
723 |
$199.10 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,127 |
926 |
$135.61 |
| D1206 |
Topical application of fluoride varnish |
1,472 |
1,449 |
$117.60 |
| 71046 |
Radiologic examination, chest; 2 views |
315 |
288 |
$93.35 |
| 0054A |
|
113 |
109 |
$80.00 |
| 0051A |
|
54 |
54 |
$80.00 |
| 17250 |
|
2,138 |
2,030 |
$75.22 |
| D1120 |
Prophylaxis - child |
1,621 |
1,596 |
$73.50 |
| 90707 |
|
12,226 |
11,949 |
$66.49 |
| 90656 |
|
9,557 |
9,404 |
$66.47 |
| D0330 |
Panoramic radiographic image |
187 |
186 |
$63.78 |
| 92557 |
|
47 |
46 |
$62.88 |
| 69209 |
|
447 |
428 |
$61.75 |
| D0140 |
Limited oral evaluation - problem focused |
27 |
27 |
$32.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
210 |
186 |
$27.17 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
6,224 |
4,678 |
$25.40 |
| D0272 |
Bitewings - two radiographic images |
312 |
311 |
$23.38 |
| 82247 |
|
1,694 |
1,257 |
$16.88 |
| D1208 |
Topical application of fluoride, excluding varnish |
106 |
105 |
$14.70 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
649 |
580 |
$14.59 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
257 |
197 |
$14.31 |
| 86703 |
|
256 |
244 |
$11.52 |
| 99173 |
|
16,260 |
15,848 |
$4.34 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
504 |
489 |
$0.70 |
| 90461 |
|
3,639 |
3,358 |
$0.09 |
| 90746 |
|
372 |
369 |
$0.02 |
| 90677 |
|
23,114 |
22,337 |
$0.02 |
| 90474 |
|
6,399 |
6,279 |
$0.01 |
| 90785 |
|
1,287 |
989 |
$0.00 |
| 1160F |
|
158,304 |
129,429 |
$0.00 |
| 99051 |
|
12,462 |
11,974 |
$0.00 |
| 3725F |
|
250 |
226 |
$0.00 |
| 3078F |
|
114,832 |
88,618 |
$0.00 |
| 3077F |
|
3,796 |
3,432 |
$0.00 |
| 91300 |
|
107 |
105 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
3,404 |
3,284 |
$0.00 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
552 |
535 |
$0.00 |
| 0502F |
|
262 |
216 |
$0.00 |
| 90713 |
|
1,117 |
1,084 |
$0.00 |
| 90714 |
|
93 |
89 |
$0.00 |
| 3210F |
|
14,326 |
11,456 |
$0.00 |
| 96160 |
|
176 |
169 |
$0.00 |
| 91321 |
|
241 |
237 |
$0.00 |
| 1159F |
|
158,091 |
129,252 |
$0.00 |
| 1090F |
|
367 |
333 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
174 |
164 |
$0.00 |
| 90380 |
|
426 |
399 |
$0.00 |
| 59426 |
|
13 |
12 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
13 |
13 |
$0.00 |
| 83655 |
|
29 |
26 |
$0.00 |
| 76818 |
|
220 |
143 |
$0.00 |
| 97803 |
|
24 |
24 |
$0.00 |
| 90750 |
|
70 |
67 |
$0.00 |
| 96130 |
|
25 |
24 |
$0.00 |
| 90655 |
|
37 |
37 |
$0.00 |
| 0071A |
|
49 |
48 |
$0.00 |
| 2028F |
|
57 |
51 |
$0.00 |
| 80305 |
|
26 |
24 |
$0.00 |
| 92552 |
|
24 |
24 |
$0.00 |
| 69210 |
|
14 |
14 |
$0.00 |
| 96137 |
|
13 |
13 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
16 |
12 |
$0.00 |
| 96136 |
|
13 |
13 |
$0.00 |
| 91312 |
|
15 |
14 |
$0.00 |
| 4000F |
|
3,706 |
3,404 |
$0.00 |
| D0602 |
|
1,655 |
1,623 |
$0.00 |
| 3074F |
|
125,675 |
95,475 |
$0.00 |
| 3079F |
|
19,352 |
16,226 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
4,883 |
4,622 |
$0.00 |
| J8540 |
Dexamethasone, oral, 0.25 mg |
435 |
418 |
$0.00 |
| 36416 |
|
1,612 |
1,512 |
$0.00 |
| 2000F |
|
130,576 |
96,711 |
$0.00 |
| 91301 |
|
33 |
31 |
$0.00 |
| 82962 |
|
395 |
373 |
$0.00 |
| 3075F |
|
7,234 |
6,404 |
$0.00 |
| J3490 |
Unclassified drugs |
651 |
604 |
$0.00 |
| 1000F |
|
88,479 |
63,084 |
$0.00 |
| 3008F |
|
85,699 |
73,920 |
$0.00 |
| 90688 |
|
78 |
76 |
$0.00 |
| D0603 |
|
2,337 |
2,302 |
$0.00 |
| 90381 |
|
640 |
635 |
$0.00 |
| 90744 |
|
1,103 |
1,066 |
$0.00 |
| 3080F |
|
2,829 |
2,545 |
$0.00 |
| 1111F |
|
135 |
129 |
$0.00 |
| 1125F |
|
7,308 |
6,736 |
$0.00 |
| D0601 |
|
1,028 |
1,004 |
$0.00 |
| 2001F |
|
185,850 |
141,733 |
$0.00 |
| J3535 |
Drug administered through a metered dose inhaler |
166 |
155 |
$0.00 |
| 91307 |
|
29 |
28 |
$0.00 |
| 1126F |
|
50,235 |
42,597 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
16 |
14 |
$0.00 |
| D1330 |
|
78 |
78 |
$0.00 |
| 1220F |
|
75,369 |
60,814 |
$0.00 |
| 97802 |
|
69 |
62 |
$0.00 |
| 1036F |
|
394 |
345 |
$0.00 |
| D1351 |
Sealant - per tooth |
58 |
14 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
99 |
98 |
$0.00 |
| 88720 |
|
19 |
15 |
$0.00 |
| 90636 |
|
26 |
26 |
$0.00 |
| J2790 |
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
249 |
229 |
$0.00 |
| 90698 |
|
100 |
93 |
$0.00 |
| 0052A |
|
13 |
13 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
28 |
26 |
$0.00 |
| 86803 |
|
14 |
14 |
$0.00 |
| 87081 |
|
59 |
55 |
$0.00 |
| 93000 |
|
19 |
17 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
47 |
43 |
$0.00 |
| 96127 |
|
47 |
46 |
$0.00 |
| 96131 |
|
12 |
12 |
$0.00 |
| 86780 |
|
54 |
53 |
$0.00 |
| 90680 |
|
101 |
93 |
$0.00 |
| 91305 |
|
12 |
12 |
$0.00 |
| J7609 |
Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg |
61 |
51 |
$0.00 |
| 1170F |
|
23 |
23 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
21 |
21 |
$0.00 |
| 1034F |
|
14 |
12 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
16 |
15 |
$0.00 |