| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
31,793 |
26,248 |
$3.32M |
| 00003 |
Internal/system code - not a standard HCPCS code |
8,470 |
7,234 |
$1.39M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,958 |
12,366 |
$17K |
| 90686 |
|
1,073 |
809 |
$13K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,586 |
2,026 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,379 |
2,875 |
$7K |
| 92551 |
|
1,365 |
892 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
187 |
128 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
176 |
136 |
$2K |
| 85018 |
|
2,681 |
1,803 |
$2K |
| 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 |
1,119 |
964 |
$2K |
| 99173 |
|
877 |
687 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
326 |
310 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
30 |
28 |
$897.36 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,195 |
1,460 |
$896.41 |
| 90670 |
|
41 |
29 |
$522.60 |
| 90715 |
|
28 |
28 |
$400.59 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
105 |
73 |
$339.98 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
50 |
36 |
$268.23 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
54 |
43 |
$244.48 |
| 90651 |
|
16 |
15 |
$175.50 |
| 99215 |
Prolong outpt/office vis |
135 |
98 |
$171.60 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
23 |
13 |
$156.12 |
| 96127 |
|
23 |
23 |
$105.82 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
50 |
39 |
$102.90 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,421 |
1,399 |
$89.92 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
74 |
51 |
$76.67 |
| 81003 |
|
30 |
28 |
$34.65 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
48 |
46 |
$22.84 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
119 |
108 |
$9.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
437 |
435 |
$2.71 |
| D1330 |
|
125 |
108 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
130 |
128 |
$0.00 |
| 3074F |
|
207 |
140 |
$0.00 |
| 2001F |
|
162 |
160 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
62 |
56 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
461 |
140 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
97 |
97 |
$0.00 |
| D0603 |
|
92 |
91 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
96 |
79 |
$0.00 |
| D1310 |
|
47 |
45 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
155 |
153 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
103 |
102 |
$0.00 |
| 3008F |
|
210 |
208 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
165 |
164 |
$0.00 |
| 1111F |
|
102 |
101 |
$0.00 |
| D1351 |
Sealant - per tooth |
41 |
17 |
$0.00 |
| 3079F |
|
58 |
44 |
$0.00 |
| 3075F |
|
24 |
17 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
56 |
56 |
$0.00 |
| D0602 |
|
13 |
13 |
$0.00 |
| 3351F |
|
41 |
41 |
$0.00 |
| 1036F |
|
267 |
184 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
22 |
15 |
$0.00 |
| 91307 |
|
42 |
38 |
$0.00 |
| 87400 |
|
17 |
17 |
$0.00 |
| 0004A |
|
50 |
50 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
141 |
139 |
$0.00 |
| D9430 |
|
283 |
273 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
95 |
95 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
172 |
132 |
$0.00 |
| D4341 |
|
203 |
146 |
$0.00 |
| 99408 |
|
140 |
139 |
$0.00 |
| D1120 |
Prophylaxis - child |
93 |
93 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
172 |
171 |
$0.00 |
| 3077F |
|
20 |
14 |
$0.00 |
| 0071A |
|
15 |
15 |
$0.00 |
| 3078F |
|
204 |
135 |
$0.00 |
| 91300 |
|
84 |
83 |
$0.00 |
| D0330 |
Panoramic radiographic image |
135 |
131 |
$0.00 |