| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
163,410 |
130,437 |
$26.71M |
| D9430 |
|
1,749 |
1,286 |
$269K |
| 90688 |
|
4,815 |
4,500 |
$48K |
| 90651 |
|
1,039 |
955 |
$8K |
| 90670 |
|
481 |
469 |
$4K |
| 90633 |
|
496 |
473 |
$4K |
| 90734 |
|
517 |
453 |
$4K |
| 90619 |
|
342 |
264 |
$2K |
| 90698 |
|
213 |
212 |
$2K |
| 90716 |
|
223 |
197 |
$2K |
| 90715 |
|
142 |
118 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,416 |
1,270 |
$821.25 |
| 91320 |
|
16 |
12 |
$818.60 |
| 90707 |
|
125 |
98 |
$760.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
788 |
674 |
$694.08 |
| 90681 |
|
79 |
79 |
$624.00 |
| 90658 |
|
61 |
61 |
$489.58 |
| 90744 |
|
55 |
55 |
$440.00 |
| 90677 |
|
52 |
52 |
$408.00 |
| 90686 |
|
38 |
32 |
$296.24 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
886 |
637 |
$229.32 |
| 90687 |
|
28 |
28 |
$224.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
67,541 |
56,284 |
$216.00 |
| 90713 |
|
26 |
26 |
$208.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,631 |
2,364 |
$140.00 |
| 90697 |
|
14 |
14 |
$112.00 |
| 90700 |
|
13 |
13 |
$104.00 |
| 90647 |
|
12 |
12 |
$96.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
581 |
551 |
$42.77 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
39,382 |
33,608 |
$37.41 |
| 92551 |
|
6,000 |
5,234 |
$10.00 |
| 3008F |
|
53,568 |
44,545 |
$0.00 |
| 3079F |
|
12,825 |
10,903 |
$0.00 |
| 3074F |
|
37,622 |
31,532 |
$0.00 |
| 92558 |
|
1,124 |
1,076 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,548 |
2,232 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
105 |
75 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
892 |
841 |
$0.00 |
| 99384 |
|
86 |
74 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
246 |
191 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
35 |
29 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
278 |
196 |
$0.00 |
| 3075F |
|
176 |
164 |
$0.00 |
| 87428 |
|
943 |
847 |
$0.00 |
| 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 |
801 |
752 |
$0.00 |
| 99383 |
|
161 |
132 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
176 |
142 |
$0.00 |
| 96127 |
|
829 |
732 |
$0.00 |
| 1125F |
|
73 |
70 |
$0.00 |
| 0012A |
|
89 |
89 |
$0.00 |
| 82962 |
|
12 |
12 |
$0.00 |
| 0011A |
|
101 |
98 |
$0.00 |
| 85018 |
|
25 |
24 |
$0.00 |
| 3080F |
|
42 |
38 |
$0.00 |
| 0001A |
|
671 |
649 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
27 |
24 |
$0.00 |
| 3044F |
|
14 |
13 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
15 |
14 |
$0.00 |
| 87807 |
|
15 |
12 |
$0.00 |
| 3078F |
|
30,545 |
25,628 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,526 |
867 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
185 |
178 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,413 |
1,260 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,294 |
1,977 |
$0.00 |
| 0004A |
|
15 |
15 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
7,151 |
6,132 |
$0.00 |
| 99223 |
Prolong inpt eval add15 m |
47 |
36 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
574 |
442 |
$0.00 |
| 3077F |
|
2,011 |
1,717 |
$0.00 |
| 0002A |
|
700 |
692 |
$0.00 |
| 81003 |
|
1,848 |
1,394 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
241 |
212 |
$0.00 |
| D1120 |
Prophylaxis - child |
451 |
369 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
539 |
498 |
$0.00 |
| 1160F |
|
611 |
589 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
787 |
688 |
$0.00 |
| D1110 |
Prophylaxis - adult |
42 |
32 |
$0.00 |
| D0330 |
Panoramic radiographic image |
43 |
29 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
51 |
38 |
$0.00 |
| 99173 |
|
38 |
38 |
$0.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
32 |
24 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
17 |
14 |
$0.00 |
| 81025 |
|
28 |
26 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
25 |
13 |
$0.00 |