| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
71,516 |
60,986 |
$10.14M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
3,213 |
1,858 |
$435K |
| 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 |
9,762 |
7,853 |
$369K |
| 99050 |
|
7,283 |
6,714 |
$342K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,847 |
1,845 |
$272K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,661 |
1,651 |
$270K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,476 |
1,474 |
$221K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
33,689 |
30,070 |
$216K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
831 |
762 |
$181K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
897 |
890 |
$155K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
836 |
824 |
$147K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,465 |
8,872 |
$101K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,029 |
7,844 |
$82K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
7,350 |
6,968 |
$73K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,273 |
905 |
$72K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
800 |
795 |
$67K |
| 99173 |
|
2,961 |
2,955 |
$66K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
2,993 |
2,542 |
$54K |
| 90834 |
Psychotherapy, 45 minutes with patient |
575 |
371 |
$49K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,286 |
3,442 |
$48K |
| 97802 |
|
577 |
575 |
$40K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
561 |
560 |
$37K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,254 |
1,150 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
507 |
505 |
$33K |
| 92015 |
Determination of refractive state |
2,452 |
2,436 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
598 |
597 |
$29K |
| 99051 |
|
1,530 |
1,480 |
$23K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,843 |
2,026 |
$21K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
857 |
811 |
$18K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,230 |
1,140 |
$17K |
| 90686 |
|
3,119 |
3,107 |
$13K |
| 90674 |
|
1,169 |
1,156 |
$13K |
| 90651 |
|
644 |
582 |
$13K |
| 90715 |
|
624 |
621 |
$13K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,394 |
1,378 |
$12K |
| D1120 |
Prophylaxis - child |
196 |
194 |
$10K |
| 97803 |
|
278 |
272 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
785 |
760 |
$9K |
| D9450 |
|
695 |
430 |
$8K |
| D1206 |
Topical application of fluoride varnish |
234 |
232 |
$6K |
| 81002 |
|
2,021 |
1,417 |
$5K |
| 90734 |
|
516 |
455 |
$5K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
70 |
67 |
$5K |
| 90670 |
|
623 |
616 |
$5K |
| 81025 |
|
745 |
712 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
86 |
85 |
$4K |
| 99381 |
|
24 |
24 |
$4K |
| 0001A |
|
98 |
98 |
$4K |
| 0002A |
|
88 |
88 |
$4K |
| D1110 |
Prophylaxis - adult |
162 |
90 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
391 |
176 |
$4K |
| S4989 |
Contraceptive intrauterine device (e.g., progestacert iud), including implants and supplies |
15 |
12 |
$3K |
| 90661 |
|
103 |
103 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,158 |
1,836 |
$2K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
72 |
71 |
$2K |
| 90716 |
|
332 |
319 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
63 |
28 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
33 |
19 |
$2K |
| 90694 |
|
200 |
161 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
52 |
28 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
83 |
41 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
49 |
37 |
$1K |
| 81000 |
|
461 |
334 |
$1K |
| 90707 |
|
338 |
336 |
$1K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,733 |
1,725 |
$1K |
| 93000 |
|
81 |
80 |
$1K |
| 90750 |
|
35 |
13 |
$996.67 |
| D0120 |
Periodic oral evaluation - established patient |
76 |
48 |
$957.00 |
| 81003 |
|
432 |
401 |
$925.32 |
| 90746 |
|
12 |
12 |
$804.72 |
| 90461 |
|
284 |
284 |
$797.04 |
| D0274 |
Bitewings - four radiographic images |
46 |
28 |
$766.00 |
| D0220 |
Intraoral - periapical first radiographic image |
72 |
35 |
$542.00 |
| 90474 |
|
68 |
68 |
$485.65 |
| D0180 |
|
22 |
12 |
$428.00 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
12 |
12 |
$371.40 |
| 99188 |
|
14 |
14 |
$364.00 |
| 86580 |
|
56 |
54 |
$326.91 |
| 0012A |
|
15 |
15 |
$323.91 |
| S3005 |
Performance measurement, evaluation of patient self assessment, depression |
39 |
39 |
$297.83 |
| G0008 |
Administration of influenza virus vaccine |
397 |
383 |
$278.82 |
| 0134A |
|
13 |
13 |
$275.23 |
| 92551 |
|
26 |
26 |
$243.88 |
| 90653 |
|
74 |
60 |
$204.88 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
512 |
456 |
$151.69 |
| 80305 |
|
17 |
12 |
$142.72 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
303 |
288 |
$117.84 |
| 87210 |
|
26 |
26 |
$109.60 |
| 91300 |
|
833 |
767 |
$80.41 |
| 0011A |
|
23 |
16 |
$33.89 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
191 |
185 |
$2.51 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
13 |
13 |
$0.09 |
| 91301 |
|
217 |
198 |
$0.08 |
| 90723 |
|
384 |
384 |
$0.00 |
| 90680 |
|
362 |
362 |
$0.00 |
| 90656 |
|
316 |
312 |
$0.00 |
| 90696 |
|
13 |
13 |
$0.00 |
| 90619 |
|
12 |
12 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
582 |
566 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
381 |
381 |
$0.00 |
| 90648 |
|
594 |
589 |
$0.00 |
| 90633 |
|
516 |
514 |
$0.00 |
| 90691 |
|
176 |
176 |
$0.00 |
| 90700 |
|
71 |
68 |
$0.00 |
| 91313 |
|
13 |
13 |
$0.00 |