| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
222,454 |
180,037 |
$36.98M |
| 00003 |
Internal/system code - not a standard HCPCS code |
77,052 |
64,734 |
$17.61M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
143,537 |
110,116 |
$4.19M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29,664 |
23,015 |
$1.15M |
| 96156 |
|
28,997 |
25,422 |
$991K |
| 90832 |
Psychotherapy, 30 minutes with patient |
37,116 |
17,557 |
$633K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27,925 |
23,304 |
$555K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17,034 |
15,885 |
$554K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
31,681 |
17,845 |
$302K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
8,498 |
7,432 |
$286K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,605 |
2,270 |
$266K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
9,431 |
8,206 |
$263K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
10,986 |
9,642 |
$248K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,815 |
1,468 |
$235K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,675 |
1,560 |
$187K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
6,095 |
5,642 |
$165K |
| 92551 |
|
24,870 |
22,163 |
$152K |
| 90461 |
|
9,488 |
7,945 |
$125K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
14,859 |
13,028 |
$120K |
| 96151 |
|
6,185 |
6,057 |
$112K |
| 90791 |
Psychiatric diagnostic evaluation |
2,427 |
1,899 |
$90K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,326 |
983 |
$73K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
816 |
485 |
$70K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,378 |
1,218 |
$67K |
| 96127 |
|
4,851 |
4,534 |
$55K |
| 90686 |
|
11,188 |
10,305 |
$55K |
| 99385 |
|
341 |
335 |
$51K |
| 97802 |
|
23,348 |
21,018 |
$42K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,688 |
1,588 |
$41K |
| 96150 |
|
1,389 |
1,359 |
$39K |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
2,591 |
2,365 |
$38K |
| 85018 |
|
30,054 |
27,600 |
$33K |
| 90651 |
|
3,697 |
3,379 |
$33K |
| 90670 |
|
4,380 |
4,263 |
$25K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
1,262 |
1,176 |
$23K |
| 90648 |
|
4,267 |
4,127 |
$21K |
| 90715 |
|
1,694 |
1,601 |
$20K |
| 90633 |
|
3,279 |
2,997 |
$19K |
| 90734 |
|
2,532 |
2,478 |
$19K |
| 36416 |
|
10,104 |
9,313 |
$17K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
987 |
751 |
$17K |
| 81003 |
|
8,890 |
7,910 |
$16K |
| 90723 |
|
2,688 |
2,629 |
$15K |
| 90710 |
|
1,954 |
1,803 |
$15K |
| 99173 |
|
16,248 |
14,690 |
$13K |
| 90619 |
|
856 |
540 |
$13K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,281 |
1,144 |
$12K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
409 |
242 |
$12K |
| 96160 |
|
2,660 |
2,444 |
$11K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
256 |
136 |
$10K |
| 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 |
652 |
546 |
$10K |
| 90620 |
|
852 |
796 |
$10K |
| 81025 |
|
3,770 |
3,413 |
$9K |
| 90696 |
|
937 |
914 |
$8K |
| 99383 |
|
142 |
128 |
$8K |
| 93000 |
|
264 |
250 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,537 |
1,296 |
$7K |
| 90681 |
|
851 |
826 |
$7K |
| 90700 |
|
758 |
735 |
$6K |
| 90688 |
|
441 |
437 |
$4K |
| 90671 |
|
903 |
614 |
$4K |
| 87428 |
|
127 |
112 |
$4K |
| 69210 |
|
56 |
55 |
$4K |
| 99384 |
|
103 |
85 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
182 |
182 |
$3K |
| 90697 |
|
587 |
412 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
271 |
244 |
$3K |
| 87490 |
|
147 |
146 |
$3K |
| 90658 |
|
341 |
340 |
$3K |
| 90674 |
|
257 |
256 |
$3K |
| J3490 |
Unclassified drugs |
28 |
26 |
$3K |
| 85999 |
|
970 |
970 |
$3K |
| 87590 |
|
147 |
146 |
$3K |
| 90716 |
|
252 |
248 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
933 |
674 |
$2K |
| 83655 |
|
186 |
185 |
$2K |
| 90707 |
|
209 |
205 |
$2K |
| 86580 |
|
155 |
148 |
$2K |
| H1000 |
Prenatal care, at-risk assessment |
12 |
12 |
$2K |
| 90656 |
|
1,156 |
749 |
$2K |
| 99406 |
|
55 |
52 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
141 |
112 |
$1K |
| 99382 |
|
13 |
13 |
$1K |
| 96158 |
|
29 |
14 |
$991.78 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
15 |
12 |
$989.56 |
| 90685 |
|
102 |
102 |
$969.20 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
483 |
307 |
$846.75 |
| 87110 |
|
104 |
104 |
$515.00 |
| 87850 |
|
104 |
104 |
$515.00 |
| 90756 |
|
20 |
20 |
$453.75 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
193 |
89 |
$281.33 |
| 90677 |
|
233 |
150 |
$277.04 |
| 82947 |
|
49 |
49 |
$217.22 |
| 81002 |
|
103 |
98 |
$201.75 |
| 82465 |
|
37 |
37 |
$155.82 |
| 98960 |
|
44,280 |
38,644 |
$155.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
892 |
714 |
$124.00 |
| 99381 |
|
35 |
31 |
$116.96 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,502 |
1,281 |
$90.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
18,513 |
7,999 |
$60.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
115 |
98 |
$45.00 |
| G9920 |
Screening performed and negative |
61 |
45 |
$37.41 |
| 1036F |
|
43,160 |
35,803 |
$28.70 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
20 |
16 |
$21.00 |
| D0272 |
Bitewings - two radiographic images |
2,741 |
2,734 |
$15.00 |
| D0220 |
Intraoral - periapical first radiographic image |
319 |
314 |
$14.00 |
| D0270 |
|
792 |
779 |
$0.00 |
| D1110 |
Prophylaxis - adult |
1,258 |
1,257 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
3,530 |
3,521 |
$0.00 |
| 1159F |
|
13,207 |
11,491 |
$0.00 |
| 1160F |
|
13,185 |
11,473 |
$0.00 |
| D9430 |
|
3,009 |
2,907 |
$0.00 |
| 3078F |
|
11,132 |
10,178 |
$0.00 |
| 4274F |
|
2,967 |
2,590 |
$0.00 |
| 4004F |
|
441 |
406 |
$0.00 |
| D1120 |
Prophylaxis - child |
8,780 |
8,749 |
$0.00 |
| D4910 |
|
900 |
897 |
$0.00 |
| 4040F |
|
596 |
513 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
4,988 |
4,334 |
$0.00 |
| D1354 |
|
2,385 |
877 |
$0.00 |
| 99442 |
|
18 |
16 |
$0.00 |
| D0350 |
|
126 |
126 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
1,084 |
1,080 |
$0.00 |
| D2751 |
Crown - porcelain fused to predominantly base metal |
13 |
13 |
$0.00 |
| D0330 |
Panoramic radiographic image |
142 |
140 |
$0.00 |
| 1003F |
|
97 |
95 |
$0.00 |
| 3077F |
|
487 |
450 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
146 |
123 |
$0.00 |
| D2999 |
|
44 |
40 |
$0.00 |
| D4341 |
|
198 |
93 |
$0.00 |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
96 |
82 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$0.00 |
| 4124F |
|
29 |
29 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
14 |
14 |
$0.00 |
| 99401 |
|
14 |
13 |
$0.00 |
| 0521 |
|
55 |
44 |
$0.00 |
| 3075F |
|
708 |
676 |
$0.00 |
| 3074F |
|
12,358 |
11,278 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
10,006 |
9,972 |
$0.00 |
| 2000F |
|
12,484 |
11,173 |
$0.00 |
| 2010F |
|
15,137 |
13,353 |
$0.00 |
| Z1034 |
|
3,913 |
2,213 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
10,755 |
10,727 |
$0.00 |
| 2001F |
|
14,886 |
13,149 |
$0.00 |
| 1000F |
|
31,942 |
26,034 |
$0.00 |
| 3008F |
|
14,841 |
13,107 |
$0.00 |
| D0603 |
|
9,525 |
9,484 |
$0.00 |
| 3079F |
|
2,566 |
2,426 |
$0.00 |
| D1330 |
|
13,075 |
12,970 |
$0.00 |
| 4010F |
|
434 |
402 |
$0.00 |
| Z1032 |
|
80 |
80 |
$0.00 |
| 3351F |
|
2,259 |
2,208 |
$0.00 |
| 1005F |
|
110 |
101 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
1,530 |
1,351 |
$0.00 |
| D0602 |
|
804 |
803 |
$0.00 |
| 3044F |
|
86 |
86 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
711 |
709 |
$0.00 |
| 1126F |
|
234 |
232 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,777 |
2,032 |
$0.00 |
| 1034F |
|
938 |
825 |
$0.00 |
| D1351 |
Sealant - per tooth |
3,577 |
1,658 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
518 |
518 |
$0.00 |
| 4037F |
|
235 |
235 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
35 |
26 |
$0.00 |
| 96161 |
|
17 |
17 |
$0.00 |
| D5999 |
|
18 |
15 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
13 |
13 |
$0.00 |
| 3080F |
|
33 |
30 |
$0.00 |
| 99000 |
|
29 |
28 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
22 |
17 |
$0.00 |
| 3352F |
|
14 |
14 |
$0.00 |