| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
118,693 |
87,155 |
$24.69M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
51,981 |
39,455 |
$1.61M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13,485 |
12,809 |
$1.39M |
| 99381 |
|
3,541 |
3,395 |
$690K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12,933 |
12,549 |
$673K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,040 |
12,481 |
$617K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
7,046 |
6,731 |
$408K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,729 |
3,594 |
$256K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
10,700 |
9,526 |
$238K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
1,903 |
400 |
$169K |
| 59430 |
|
4,189 |
3,775 |
$169K |
| 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 |
2,487 |
2,295 |
$83K |
| 87428 |
|
2,753 |
2,549 |
$61K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,506 |
1,238 |
$58K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
415 |
391 |
$35K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,329 |
3,344 |
$34K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
473 |
154 |
$32K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
581 |
183 |
$31K |
| 90715 |
|
4,409 |
4,144 |
$25K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
392 |
301 |
$23K |
| 99215 |
Prolong outpt/office vis |
298 |
263 |
$21K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
5,652 |
4,871 |
$20K |
| 90651 |
|
2,015 |
1,961 |
$19K |
| 81002 |
|
15,343 |
10,023 |
$14K |
| 90834 |
Psychotherapy, 45 minutes with patient |
230 |
202 |
$13K |
| D9420 |
|
525 |
462 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
207 |
192 |
$12K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
469 |
432 |
$10K |
| 90791 |
Psychiatric diagnostic evaluation |
142 |
101 |
$9K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
441 |
417 |
$8K |
| 90461 |
|
2,153 |
1,356 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28,397 |
27,224 |
$6K |
| 90686 |
|
11,189 |
10,754 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
108 |
107 |
$5K |
| 0002A |
|
307 |
276 |
$5K |
| 90480 |
|
428 |
416 |
$4K |
| 0071A |
|
110 |
103 |
$4K |
| 81025 |
|
2,168 |
1,956 |
$4K |
| 0012A |
|
205 |
176 |
$4K |
| 0001A |
|
330 |
298 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
377 |
331 |
$3K |
| 97802 |
|
690 |
651 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
462 |
422 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
26,515 |
14,192 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
329 |
137 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
464 |
369 |
$3K |
| 99383 |
|
29 |
28 |
$2K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
61 |
25 |
$2K |
| D1351 |
Sealant - per tooth |
80 |
25 |
$2K |
| 0011A |
|
188 |
160 |
$2K |
| 96380 |
|
344 |
335 |
$1K |
| 90620 |
|
775 |
752 |
$1K |
| 90716 |
|
2,409 |
2,333 |
$1K |
| 0013A |
|
83 |
77 |
$1K |
| 90656 |
|
1,025 |
1,008 |
$1K |
| 0124A |
|
58 |
57 |
$1K |
| 97803 |
|
644 |
592 |
$1K |
| 91320 |
|
117 |
115 |
$1K |
| 90707 |
|
2,302 |
2,233 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
767 |
737 |
$862.67 |
| 76801 |
|
28 |
24 |
$772.30 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
626 |
530 |
$682.00 |
| 90677 |
|
1,885 |
1,806 |
$543.90 |
| D0272 |
Bitewings - two radiographic images |
40 |
25 |
$490.98 |
| 0054A |
|
33 |
30 |
$396.00 |
| 96156 |
|
63 |
41 |
$377.25 |
| 96160 |
|
249 |
239 |
$318.64 |
| 90619 |
|
736 |
722 |
$214.42 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
75 |
75 |
$205.82 |
| D0240 |
|
41 |
13 |
$196.00 |
| 90474 |
|
3,169 |
3,052 |
$190.46 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
184 |
155 |
$186.47 |
| 92551 |
|
1,940 |
1,882 |
$149.38 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
72 |
69 |
$137.59 |
| 91301 |
|
752 |
596 |
$107.13 |
| 0003A |
|
12 |
12 |
$80.00 |
| 90734 |
|
734 |
698 |
$77.98 |
| 90688 |
|
583 |
513 |
$73.62 |
| 93000 |
|
14 |
13 |
$58.61 |
| 90648 |
|
7,491 |
7,254 |
$0.00 |
| 90670 |
|
6,434 |
6,187 |
$0.00 |
| 90633 |
|
4,937 |
4,789 |
$0.00 |
| 90710 |
|
1,678 |
1,625 |
$0.00 |
| 90649 |
|
61 |
57 |
$0.00 |
| 90700 |
|
2,260 |
2,192 |
$0.00 |
| 90473 |
|
281 |
268 |
$0.00 |
| 90681 |
|
5,158 |
4,952 |
$0.00 |
| 90671 |
|
1,953 |
1,924 |
$0.00 |
| 91300 |
|
754 |
606 |
$0.00 |
| 90380 |
|
89 |
88 |
$0.00 |
| 90655 |
|
124 |
124 |
$0.00 |
| 99173 |
|
852 |
820 |
$0.00 |
| 91312 |
|
58 |
57 |
$0.00 |
| 90750 |
|
13 |
13 |
$0.00 |
| 90662 |
|
18 |
15 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
36 |
35 |
$0.00 |
| 91308 |
|
17 |
12 |
$0.00 |
| 90723 |
|
5,258 |
5,080 |
$0.00 |
| 96161 |
|
159 |
155 |
$0.00 |
| 99607 |
|
32 |
26 |
$0.00 |
| 99606 |
|
351 |
273 |
$0.00 |
| 91305 |
|
101 |
94 |
$0.00 |
| 90698 |
|
2,676 |
2,562 |
$0.00 |
| 90696 |
|
1,556 |
1,505 |
$0.00 |
| 82962 |
|
1,079 |
945 |
$0.00 |
| 91307 |
|
197 |
187 |
$0.00 |
| 90744 |
|
146 |
144 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
28 |
28 |
$0.00 |
| 91318 |
|
93 |
91 |
$0.00 |
| 90381 |
|
195 |
191 |
$0.00 |
| 90657 |
|
13 |
12 |
$0.00 |
| 92250 |
|
13 |
13 |
$0.00 |