| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
105,308 |
71,450 |
$5.64M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
64,168 |
35,717 |
$1.21M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
20,891 |
10,781 |
$301K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,800 |
5,212 |
$227K |
| 90837 |
Psychotherapy, 53 minutes with patient |
4,634 |
1,350 |
$148K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
8,609 |
5,336 |
$127K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
7,156 |
4,543 |
$94K |
| 76801 |
|
2,687 |
1,452 |
$83K |
| 92015 |
Determination of refractive state |
17,325 |
11,238 |
$73K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,992 |
4,242 |
$57K |
| 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 |
3,549 |
2,834 |
$48K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,959 |
1,054 |
$46K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
925 |
599 |
$44K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,400 |
1,423 |
$41K |
| 92341 |
|
4,189 |
2,662 |
$38K |
| D1110 |
Prophylaxis - adult |
3,871 |
2,440 |
$37K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,061 |
2,562 |
$32K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
9,674 |
5,821 |
$30K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
621 |
342 |
$22K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,054 |
405 |
$22K |
| 97803 |
|
1,225 |
802 |
$22K |
| D0330 |
Panoramic radiographic image |
2,177 |
1,123 |
$21K |
| D0210 |
Intraoral - complete series of radiographic images |
1,407 |
1,035 |
$21K |
| 81002 |
|
21,660 |
9,556 |
$19K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,345 |
1,289 |
$17K |
| V2020 |
Frames, purchases |
1,729 |
1,529 |
$16K |
| 90686 |
|
2,853 |
1,534 |
$15K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
928 |
632 |
$13K |
| D0120 |
Periodic oral evaluation - established patient |
1,690 |
1,160 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
705 |
447 |
$12K |
| 36416 |
|
10,013 |
5,981 |
$11K |
| 81025 |
|
3,125 |
2,045 |
$10K |
| 99078 |
|
720 |
259 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
515 |
291 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,452 |
973 |
$10K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
557 |
389 |
$10K |
| 99442 |
|
855 |
430 |
$9K |
| 97802 |
|
431 |
256 |
$9K |
| D0230 |
Intraoral - periapical each additional radiographic image |
8,562 |
1,457 |
$8K |
| D1206 |
Topical application of fluoride varnish |
875 |
686 |
$7K |
| D1120 |
Prophylaxis - child |
623 |
510 |
$7K |
| D0274 |
Bitewings - four radiographic images |
2,436 |
1,486 |
$7K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
318 |
185 |
$7K |
| 96127 |
|
4,044 |
2,064 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
236 |
136 |
$6K |
| 59430 |
|
195 |
116 |
$6K |
| 82962 |
|
5,926 |
3,527 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,336 |
1,154 |
$5K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
141 |
72 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
3,748 |
2,190 |
$3K |
| D2140 |
|
230 |
99 |
$3K |
| D7140 |
Extraction, erupted tooth or exposed root |
215 |
110 |
$3K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
67 |
40 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
217 |
182 |
$2K |
| 90670 |
|
439 |
274 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
182 |
131 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
441 |
257 |
$2K |
| 90715 |
|
163 |
101 |
$2K |
| 99441 |
|
335 |
188 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
158 |
131 |
$2K |
| H1000 |
Prenatal care, at-risk assessment |
52 |
26 |
$2K |
| 99215 |
Prolong outpt/office vis |
33 |
19 |
$1K |
| 99385 |
|
138 |
106 |
$957.84 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
48 |
37 |
$895.40 |
| 92551 |
|
323 |
192 |
$888.79 |
| 99454 |
|
43 |
26 |
$780.26 |
| D2160 |
|
33 |
24 |
$715.00 |
| 99386 |
|
22 |
12 |
$449.35 |
| 90656 |
|
39 |
39 |
$436.68 |
| 99173 |
|
353 |
224 |
$342.18 |
| 99406 |
|
60 |
34 |
$292.14 |
| D0272 |
Bitewings - two radiographic images |
74 |
55 |
$280.00 |
| 92133 |
|
48 |
40 |
$255.36 |
| 80305 |
|
32 |
14 |
$162.62 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$72.00 |
| 90633 |
|
43 |
27 |
$60.00 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
16 |
14 |
$29.76 |
| 3044F |
|
585 |
335 |
$20.45 |
| 86580 |
|
19 |
14 |
$18.60 |
| 3074F |
|
1,638 |
845 |
$14.38 |
| 3078F |
|
1,683 |
877 |
$3.63 |
| 3079F |
|
1,061 |
490 |
$2.14 |
| 3075F |
|
708 |
322 |
$1.43 |
| 3077F |
|
432 |
200 |
$0.77 |
| 3080F |
|
192 |
85 |
$0.36 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
10,918 |
6,427 |
$0.00 |
| 1036F |
|
1,828 |
931 |
$0.00 |
| 3008F |
|
203 |
156 |
$0.00 |
| 90688 |
|
91 |
52 |
$0.00 |
| 4000F |
|
299 |
228 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
2,610 |
1,537 |
$0.00 |
| 90723 |
|
67 |
40 |
$0.00 |
| 90647 |
|
137 |
80 |
$0.00 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
12 |
12 |
$0.00 |
| D1330 |
|
46 |
40 |
$0.00 |
| 90716 |
|
22 |
15 |
$0.00 |
| D3120 |
|
50 |
29 |
$0.00 |
| 90697 |
|
21 |
12 |
$0.00 |
| 2023F |
|
87 |
42 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
10,065 |
5,947 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
3,473 |
2,024 |
$0.00 |
| 99071 |
|
6,288 |
3,215 |
$0.00 |
| 4004F |
|
1,374 |
738 |
$0.00 |
| 2022F |
|
181 |
110 |
$0.00 |
| D0190 |
|
674 |
358 |
$0.00 |
| 3045F |
|
70 |
54 |
$0.00 |
| 90700 |
|
38 |
24 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
23 |
12 |
$0.00 |
| 90681 |
|
24 |
13 |
$0.00 |
| 90707 |
|
21 |
13 |
$0.00 |
| 2028F |
|
49 |
25 |
$0.00 |