| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
125,216 |
78,173 |
$17.57M |
| 00003 |
Internal/system code - not a standard HCPCS code |
43,075 |
23,463 |
$6.58M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
111,028 |
84,847 |
$1.58M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,437 |
3,352 |
$249K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26,573 |
23,306 |
$132K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
3,891 |
2,347 |
$108K |
| A4267 |
Contraceptive supply, condom, male, each |
2,936 |
2,840 |
$44K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,081 |
8,738 |
$43K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,669 |
1,662 |
$30K |
| J3490 |
Unclassified drugs |
273 |
246 |
$25K |
| D4910 |
|
786 |
760 |
$23K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,393 |
1,382 |
$22K |
| D0120 |
Periodic oral evaluation - established patient |
2,246 |
2,157 |
$20K |
| 92081 |
|
7,666 |
7,640 |
$18K |
| 92557 |
|
4,355 |
4,337 |
$15K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,012 |
1,933 |
$13K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,039 |
2,029 |
$13K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,162 |
2,154 |
$12K |
| 59425 |
|
2,227 |
1,357 |
$11K |
| G9920 |
Screening performed and negative |
2,537 |
2,491 |
$11K |
| D0274 |
Bitewings - four radiographic images |
2,127 |
2,024 |
$10K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,455 |
1,749 |
$10K |
| 81025 |
|
6,366 |
6,199 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,080 |
2,078 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
667 |
640 |
$9K |
| D4341 |
|
451 |
199 |
$8K |
| D0220 |
Intraoral - periapical first radiographic image |
2,985 |
2,685 |
$7K |
| D9430 |
|
1,264 |
1,056 |
$6K |
| D1110 |
Prophylaxis - adult |
482 |
469 |
$6K |
| 0001A |
|
1,077 |
1,013 |
$6K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
483 |
467 |
$6K |
| 59430 |
|
430 |
376 |
$6K |
| D0210 |
Intraoral - complete series of radiographic images |
526 |
511 |
$6K |
| 90649 |
|
604 |
594 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,669 |
1,665 |
$5K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
1,167 |
1,096 |
$5K |
| 90791 |
Psychiatric diagnostic evaluation |
469 |
464 |
$4K |
| 93000 |
|
1,469 |
1,459 |
$4K |
| 81001 |
|
1,248 |
791 |
$4K |
| 81002 |
|
7,156 |
6,303 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,438 |
2,221 |
$4K |
| 92552 |
|
2,651 |
2,634 |
$3K |
| 90734 |
|
723 |
719 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,877 |
4,810 |
$2K |
| D1120 |
Prophylaxis - child |
187 |
184 |
$2K |
| 90686 |
|
1,488 |
1,477 |
$2K |
| 90688 |
|
664 |
660 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
411 |
408 |
$2K |
| 93040 |
|
1,212 |
1,205 |
$2K |
| 90658 |
|
278 |
273 |
$2K |
| 0002A |
|
626 |
607 |
$2K |
| 96156 |
|
447 |
446 |
$2K |
| 76801 |
|
83 |
80 |
$1K |
| 85018 |
|
5,506 |
5,445 |
$1K |
| 99401 |
|
285 |
279 |
$1K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
30 |
26 |
$1K |
| 85014 |
|
2,551 |
2,516 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,053 |
1,041 |
$1K |
| 90620 |
|
199 |
196 |
$1K |
| 90670 |
|
85 |
85 |
$1K |
| 90715 |
|
448 |
445 |
$1K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
101 |
101 |
$990.19 |
| 90716 |
|
133 |
132 |
$948.00 |
| 91300 |
|
1,410 |
1,343 |
$871.11 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
229 |
223 |
$806.66 |
| 90707 |
|
125 |
125 |
$702.53 |
| 90682 |
|
242 |
242 |
$540.47 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,434 |
1,407 |
$514.57 |
| 88150 |
|
1,728 |
1,727 |
$504.12 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
929 |
923 |
$488.04 |
| 90651 |
|
370 |
369 |
$468.00 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
282 |
199 |
$447.78 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
62 |
59 |
$331.04 |
| 99215 |
Prolong outpt/office vis |
246 |
246 |
$309.82 |
| 86580 |
|
569 |
558 |
$290.23 |
| 99201 |
|
18 |
13 |
$287.26 |
| 90700 |
|
117 |
117 |
$284.52 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
13 |
13 |
$259.19 |
| 90662 |
|
69 |
68 |
$235.60 |
| 36415 |
Collection of venous blood by venipuncture |
7,818 |
7,605 |
$223.20 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
26 |
13 |
$203.00 |
| 82962 |
|
1,357 |
1,234 |
$163.10 |
| 90656 |
|
227 |
226 |
$152.81 |
| 97803 |
|
46 |
43 |
$130.65 |
| 69210 |
|
15 |
13 |
$116.00 |
| 90461 |
|
332 |
330 |
$107.52 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
206 |
184 |
$100.15 |
| 97802 |
|
18 |
18 |
$100.13 |
| 99173 |
|
1,192 |
1,186 |
$98.07 |
| 90633 |
|
40 |
40 |
$90.00 |
| 90756 |
|
45 |
45 |
$84.03 |
| 90713 |
|
40 |
39 |
$81.87 |
| 90647 |
|
12 |
12 |
$68.30 |
| 90671 |
|
26 |
25 |
$63.00 |
| 3074F |
|
11,240 |
10,330 |
$57.69 |
| 99000 |
|
457 |
437 |
$57.36 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
1,967 |
1,962 |
$49.58 |
| D0140 |
Limited oral evaluation - problem focused |
47 |
39 |
$46.20 |
| H2000 |
Comprehensive multidisciplinary evaluation |
24 |
24 |
$41.73 |
| 3078F |
|
10,206 |
9,460 |
$40.29 |
| 3008F |
|
14,737 |
13,489 |
$33.61 |
| 3079F |
|
2,818 |
2,705 |
$29.00 |
| D0272 |
Bitewings - two radiographic images |
26 |
25 |
$24.00 |
| 1160F |
|
11,623 |
9,682 |
$23.49 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
14 |
$22.25 |
| 1158F |
|
312 |
311 |
$18.00 |
| 0011A |
|
96 |
96 |
$17.92 |
| D0603 |
|
2,010 |
1,956 |
$10.00 |
| 1159F |
|
16,683 |
13,466 |
$9.02 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
300 |
300 |
$0.03 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
792 |
789 |
$0.00 |
| 3077F |
|
450 |
441 |
$0.00 |
| 3046F |
|
143 |
122 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
28 |
28 |
$0.00 |
| 3015F |
|
92 |
91 |
$0.00 |
| 3725F |
|
465 |
463 |
$0.00 |
| 99072 |
|
49 |
49 |
$0.00 |
| 1124F |
|
17 |
17 |
$0.00 |
| 3051F |
|
185 |
157 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
18 |
18 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
12 |
12 |
$0.00 |
| 90672 |
|
20 |
20 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
841 |
837 |
$0.00 |
| D0602 |
|
114 |
112 |
$0.00 |
| D1330 |
|
1,122 |
1,093 |
$0.00 |
| 1036F |
|
13,027 |
10,621 |
$0.00 |
| 3044F |
|
2,735 |
2,300 |
$0.00 |
| 3017F |
|
80 |
78 |
$0.00 |
| 1157F |
|
120 |
117 |
$0.00 |
| 3075F |
|
1,690 |
1,637 |
$0.00 |
| 3080F |
|
157 |
154 |
$0.00 |
| 3014F |
|
108 |
105 |
$0.00 |
| 1034F |
|
810 |
661 |
$0.00 |
| 91301 |
|
139 |
139 |
$0.00 |
| 99441 |
|
312 |
232 |
$0.00 |
| 0012A |
|
64 |
64 |
$0.00 |
| 3052F |
|
77 |
69 |
$0.00 |
| 57454 |
|
12 |
12 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
49 |
49 |
$0.00 |
| 99384 |
|
14 |
14 |
$0.00 |
| 1123F |
|
104 |
103 |
$0.00 |
| 1126F |
|
60 |
60 |
$0.00 |
| 92567 |
|
14 |
14 |
$0.00 |
| 1125F |
|
12 |
12 |
$0.00 |