| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
34,516 |
27,433 |
$13.55M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,652 |
7,809 |
$353K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,546 |
3,003 |
$155K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,254 |
1,671 |
$100K |
| 90837 |
Psychotherapy, 53 minutes with patient |
885 |
467 |
$67K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,691 |
904 |
$62K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,070 |
1,847 |
$58K |
| D1206 |
Topical application of fluoride varnish |
2,420 |
2,289 |
$30K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,854 |
583 |
$21K |
| D0140 |
Limited oral evaluation - problem focused |
771 |
732 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
254 |
205 |
$15K |
| D1999 |
|
793 |
663 |
$10K |
| D1120 |
Prophylaxis - child |
490 |
483 |
$9K |
| D1110 |
Prophylaxis - adult |
295 |
290 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
79 |
72 |
$7K |
| 97035 |
|
1,289 |
375 |
$6K |
| D0190 |
|
1,917 |
1,821 |
$5K |
| 0012A |
|
152 |
136 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
150 |
140 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
518 |
505 |
$4K |
| D1351 |
Sealant - per tooth |
298 |
65 |
$4K |
| 92015 |
Determination of refractive state |
360 |
288 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
156 |
152 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
68 |
52 |
$3K |
| 0011A |
|
182 |
168 |
$3K |
| 97014 |
|
330 |
109 |
$3K |
| 97161 |
|
68 |
51 |
$2K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
132 |
131 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
162 |
161 |
$2K |
| 90674 |
|
93 |
74 |
$2K |
| 96127 |
|
1,012 |
929 |
$2K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
37 |
24 |
$1K |
| D7140 |
Extraction, erupted tooth or exposed root |
53 |
24 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
88 |
44 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
108 |
91 |
$1K |
| 90686 |
|
145 |
132 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
228 |
200 |
$1K |
| 0013A |
|
33 |
33 |
$1K |
| 0002A |
|
29 |
29 |
$1K |
| 0072A |
|
28 |
24 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
29 |
29 |
$1K |
| 0001A |
|
25 |
25 |
$1K |
| D0330 |
Panoramic radiographic image |
35 |
34 |
$975.43 |
| 0071A |
|
24 |
24 |
$960.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
118 |
104 |
$936.03 |
| 0003A |
|
24 |
24 |
$920.00 |
| D0274 |
Bitewings - four radiographic images |
76 |
76 |
$899.60 |
| 80061 |
Lipid panel |
74 |
66 |
$879.54 |
| 97804 |
|
72 |
70 |
$677.34 |
| 36415 |
Collection of venous blood by venipuncture |
181 |
170 |
$667.94 |
| 80053 |
Comprehensive metabolic panel |
71 |
66 |
$609.93 |
| 97032 |
|
51 |
15 |
$360.80 |
| D1354 |
|
69 |
12 |
$227.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$208.65 |
| 90661 |
|
20 |
20 |
$200.78 |
| 90620 |
|
12 |
12 |
$196.50 |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
16 |
12 |
$193.33 |
| 81003 |
|
62 |
51 |
$105.86 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
12 |
12 |
$77.77 |
| 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 |
3,207 |
2,319 |
$29.00 |
| D0603 |
|
319 |
315 |
$0.00 |
| 91301 |
|
438 |
404 |
$0.00 |
| 91307 |
|
72 |
66 |
$0.00 |
| 91300 |
|
134 |
131 |
$0.00 |