| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17,595 |
13,791 |
$477K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,133 |
4,829 |
$211K |
| H1000 |
Prenatal care, at-risk assessment |
2,390 |
1,375 |
$84K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
1,174 |
711 |
$55K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
1,755 |
877 |
$44K |
| T1015 |
Clinic visit/encounter, all-inclusive |
739 |
507 |
$29K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,313 |
1,157 |
$28K |
| 99385 |
|
163 |
118 |
$7K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
141 |
115 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
210 |
165 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
74 |
63 |
$4K |
| 90832 |
Psychotherapy, 30 minutes with patient |
193 |
176 |
$4K |
| H2000 |
Comprehensive multidisciplinary evaluation |
44 |
24 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
74 |
63 |
$3K |
| H0046 |
Mental health services, not otherwise specified |
683 |
440 |
$3K |
| H0047 |
Alcohol and/or other drug abuse services, not otherwise specified |
441 |
305 |
$3K |
| 96127 |
|
18,556 |
13,294 |
$3K |
| 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 |
241 |
183 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
45 |
44 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
3,384 |
2,997 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
496 |
301 |
$917.33 |
| D0210 |
Intraoral - complete series of radiographic images |
29 |
27 |
$902.75 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
89 |
85 |
$860.64 |
| D1330 |
|
153 |
140 |
$765.37 |
| 3351F |
|
18,405 |
13,757 |
$717.65 |
| 0012A |
|
16 |
16 |
$600.00 |
| 91301 |
|
63 |
62 |
$600.00 |
| 0011A |
|
38 |
38 |
$560.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
52 |
18 |
$321.52 |
| 99383 |
|
24 |
12 |
$250.04 |
| 81025 |
|
279 |
203 |
$169.72 |
| 93000 |
|
57 |
55 |
$156.03 |
| 1159F |
|
10,366 |
8,093 |
$128.25 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
174 |
88 |
$105.50 |
| 3008F |
|
16,318 |
12,148 |
$95.28 |
| 81002 |
|
1,111 |
582 |
$78.59 |
| 84443 |
Thyroid stimulating hormone (TSH) |
43 |
43 |
$55.85 |
| 80053 |
Comprehensive metabolic panel |
82 |
80 |
$47.79 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
23 |
19 |
$46.98 |
| 3354F |
|
177 |
107 |
$40.12 |
| 1000F |
|
19,338 |
13,927 |
$39.21 |
| 90658 |
|
29 |
16 |
$26.12 |
| 82962 |
|
86 |
43 |
$22.30 |
| 1160F |
|
10,305 |
8,058 |
$9.80 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
15 |
12 |
$9.16 |
| 3352F |
|
359 |
291 |
$2.09 |
| 1126F |
|
5,601 |
4,541 |
$0.21 |
| 3044F |
|
3,673 |
2,770 |
$0.18 |
| 3078F |
|
7,147 |
5,316 |
$0.08 |
| 3074F |
|
7,686 |
5,736 |
$0.07 |
| 1125F |
|
1,221 |
1,050 |
$0.06 |
| 2000F |
|
4,850 |
3,371 |
$0.05 |
| 0513F |
|
6,443 |
4,514 |
$0.04 |
| 4450F |
|
65 |
61 |
$0.04 |
| 3017F |
|
166 |
81 |
$0.02 |
| 1111F |
|
391 |
361 |
$0.01 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$0.00 |
| 1033F |
|
2,955 |
2,541 |
$0.00 |
| 99408 |
|
790 |
556 |
$0.00 |
| 4004F |
|
33 |
30 |
$0.00 |
| 3077F |
|
299 |
202 |
$0.00 |
| 97803 |
|
14 |
14 |
$0.00 |
| 3079F |
|
1,402 |
1,011 |
$0.00 |
| 2001F |
|
5,078 |
3,517 |
$0.00 |
| 1220F |
|
5,650 |
3,726 |
$0.00 |
| 1123F |
|
1,805 |
1,634 |
$0.00 |
| 4050F |
|
506 |
330 |
$0.00 |
| 3075F |
|
611 |
438 |
$0.00 |
| 1036F |
|
359 |
313 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
12 |
$0.00 |
| 4000F |
|
623 |
424 |
$0.00 |
| 1157F |
|
130 |
117 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
28 |
28 |
$0.00 |
| 3353F |
|
33 |
29 |
$0.00 |
| 81001 |
|
15 |
12 |
$0.00 |
| 86592 |
|
14 |
13 |
$0.00 |