| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
21,129 |
17,395 |
$3.03M |
| 00003 |
Internal/system code - not a standard HCPCS code |
6,349 |
5,381 |
$1.22M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,902 |
7,452 |
$14K |
| 90791 |
Psychiatric diagnostic evaluation |
345 |
283 |
$7K |
| 90832 |
Psychotherapy, 30 minutes with patient |
858 |
523 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,839 |
1,266 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
494 |
317 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,905 |
1,541 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,356 |
2,009 |
$1K |
| 90686 |
|
2,173 |
1,913 |
$948.45 |
| 90688 |
|
82 |
74 |
$748.14 |
| 96156 |
|
3,819 |
3,101 |
$725.40 |
| 90461 |
|
1,127 |
987 |
$695.02 |
| 3008F |
|
15,706 |
11,387 |
$182.00 |
| 92551 |
|
2,847 |
2,303 |
$165.63 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
381 |
292 |
$135.00 |
| 99173 |
|
3,894 |
3,117 |
$134.00 |
| 99000 |
|
1,736 |
1,420 |
$125.45 |
| 94760 |
|
9,847 |
6,826 |
$120.54 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
593 |
561 |
$102.46 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
208 |
151 |
$101.87 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
102 |
71 |
$90.01 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
699 |
599 |
$83.04 |
| 85018 |
|
2,293 |
1,945 |
$75.51 |
| 86580 |
|
125 |
119 |
$62.61 |
| 90670 |
|
391 |
354 |
$60.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
167 |
158 |
$56.00 |
| 90651 |
|
212 |
163 |
$55.00 |
| 81025 |
|
399 |
363 |
$53.17 |
| 99385 |
|
60 |
37 |
$42.00 |
| 90633 |
|
396 |
354 |
$36.00 |
| 90677 |
|
38 |
30 |
$27.00 |
| 90734 |
|
115 |
90 |
$18.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
354 |
330 |
$17.17 |
| 99384 |
|
34 |
18 |
$14.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
691 |
515 |
$0.00 |
| 97803 |
|
195 |
129 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
925 |
622 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
189 |
189 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
218 |
163 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
73 |
58 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
414 |
332 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
367 |
352 |
$0.00 |
| 3078F |
|
2,512 |
1,693 |
$0.00 |
| Z6400 |
|
189 |
157 |
$0.00 |
| D1110 |
Prophylaxis - adult |
92 |
92 |
$0.00 |
| D1120 |
Prophylaxis - child |
411 |
411 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
100 |
100 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
364 |
273 |
$0.00 |
| 3077F |
|
391 |
281 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
730 |
646 |
$0.00 |
| D9430 |
|
72 |
71 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
374 |
292 |
$0.00 |
| Z6500 |
|
12 |
12 |
$0.00 |
| D4341 |
|
78 |
61 |
$0.00 |
| 90715 |
|
80 |
76 |
$0.00 |
| Z6304 |
|
70 |
70 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
132 |
95 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
18 |
13 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
35 |
27 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
33 |
25 |
$0.00 |
| 3725F |
|
16 |
16 |
$0.00 |
| 2014F |
|
71 |
69 |
$0.00 |
| 0521F |
|
82 |
55 |
$0.00 |
| 81002 |
|
14 |
13 |
$0.00 |
| 90713 |
|
20 |
20 |
$0.00 |
| 90681 |
|
40 |
38 |
$0.00 |
| 99401 |
|
17 |
14 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 96160 |
|
16 |
15 |
$0.00 |
| 90674 |
|
18 |
13 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
21 |
17 |
$0.00 |
| D0602 |
|
119 |
119 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
261 |
223 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,472 |
1,077 |
$0.00 |
| Z6204 |
|
71 |
71 |
$0.00 |
| 1031F |
|
650 |
508 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
674 |
487 |
$0.00 |
| 1036F |
|
578 |
454 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
823 |
506 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
378 |
378 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
657 |
657 |
$0.00 |
| 3079F |
|
443 |
311 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
840 |
840 |
$0.00 |
| 3074F |
|
2,576 |
1,733 |
$0.00 |
| D0603 |
|
1,326 |
1,326 |
$0.00 |
| Z1034 |
|
1,449 |
1,008 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
194 |
142 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
542 |
542 |
$0.00 |
| 90716 |
|
39 |
36 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
373 |
160 |
$0.00 |
| 90697 |
|
156 |
142 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
813 |
653 |
$0.00 |
| 1000F |
|
798 |
631 |
$0.00 |
| Z6410 |
|
237 |
204 |
$0.00 |
| 3080F |
|
256 |
182 |
$0.00 |
| 90698 |
|
65 |
59 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
502 |
384 |
$0.00 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
134 |
88 |
$0.00 |
| 97802 |
|
669 |
495 |
$0.00 |
| 3075F |
|
317 |
224 |
$0.00 |
| 96127 |
|
412 |
329 |
$0.00 |
| G8952 |
Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given |
17 |
12 |
$0.00 |
| 96161 |
|
156 |
119 |
$0.00 |
| 3017F |
|
42 |
28 |
$0.00 |
| Z1032 |
|
74 |
58 |
$0.00 |
| 82962 |
|
32 |
25 |
$0.00 |
| 90744 |
|
131 |
121 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
41 |
27 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
750 |
500 |
$0.00 |
| 99383 |
|
71 |
66 |
$0.00 |
| Z6406 |
|
70 |
70 |
$0.00 |
| 99381 |
|
14 |
12 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
40 |
31 |
$0.00 |
| 90620 |
|
15 |
12 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
41 |
30 |
$0.00 |
| 1125F |
|
83 |
57 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
17 |
15 |
$0.00 |