| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
109,380 |
96,601 |
$16.39M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
59,245 |
53,209 |
$151K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
950 |
945 |
$129K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
42 |
42 |
$84K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
639 |
617 |
$49K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,667 |
3,417 |
$40K |
| 0012A |
|
805 |
805 |
$30K |
| 0011A |
|
815 |
814 |
$29K |
| 76830 |
Ultrasound, transvaginal |
210 |
205 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,472 |
9,126 |
$15K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
13 |
13 |
$14K |
| 0002A |
|
347 |
343 |
$13K |
| 0001A |
|
345 |
344 |
$13K |
| G9016 |
Smoking cessation counseling, individual, in the absence of or in addition to any other evaluation and management service, per session (6-10 minutes) [demo project code only] |
767 |
596 |
$11K |
| T1001 |
Nursing assessment / evaluation |
60 |
60 |
$10K |
| 0071A |
|
167 |
167 |
$6K |
| 0064A |
|
154 |
153 |
$6K |
| 0072A |
|
131 |
130 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,720 |
2,700 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,442 |
1,424 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,334 |
5,134 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
470 |
348 |
$3K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
28 |
15 |
$2K |
| 99460 |
|
48 |
48 |
$1K |
| 0004A |
|
36 |
36 |
$1K |
| 96127 |
|
1,577 |
1,550 |
$1K |
| 90686 |
|
1,520 |
1,502 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
540 |
534 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,438 |
2,361 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,039 |
542 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
12 |
12 |
$963.49 |
| 0134A |
|
21 |
21 |
$840.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
39 |
39 |
$512.55 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
53 |
53 |
$259.00 |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
67 |
66 |
$221.09 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
67 |
64 |
$175.64 |
| 90715 |
|
1,156 |
1,149 |
$47.52 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,091 |
3,060 |
$40.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,137 |
1,017 |
$20.97 |
| 90633 |
|
1,783 |
1,778 |
$20.00 |
| 94727 |
|
13 |
13 |
$19.24 |
| 94060 |
|
13 |
13 |
$15.20 |
| 85018 |
|
1,654 |
1,640 |
$13.65 |
| 90651 |
|
1,136 |
1,050 |
$10.00 |
| 90680 |
|
1,287 |
1,280 |
$10.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
756 |
754 |
$10.00 |
| 90670 |
|
2,643 |
2,632 |
$10.00 |
| 3008F |
|
33,939 |
30,656 |
$0.00 |
| 90744 |
|
460 |
453 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
67 |
48 |
$0.00 |
| 3074F |
|
1,702 |
1,602 |
$0.00 |
| WA078 |
|
17 |
17 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
64 |
55 |
$0.00 |
| 87807 |
|
111 |
108 |
$0.00 |
| 90723 |
|
511 |
509 |
$0.00 |
| 90647 |
|
576 |
575 |
$0.00 |
| 90688 |
|
1,394 |
1,392 |
$0.00 |
| 3079F |
|
1,111 |
1,072 |
$0.00 |
| 90696 |
|
530 |
530 |
$0.00 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
629 |
625 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
659 |
610 |
$0.00 |
| 90698 |
|
689 |
688 |
$0.00 |
| 90619 |
|
338 |
336 |
$0.00 |
| 90697 |
|
237 |
231 |
$0.00 |
| 90716 |
|
322 |
320 |
$0.00 |
| 3080F |
|
203 |
191 |
$0.00 |
| 3075F |
|
147 |
142 |
$0.00 |
| 92551 |
|
12 |
12 |
$0.00 |
| D0603 |
|
41 |
41 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
599 |
562 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
138 |
122 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
167 |
136 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
25 |
25 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
191 |
184 |
$0.00 |
| 81000 |
|
28 |
25 |
$0.00 |
| 90620 |
|
32 |
32 |
$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 |
24 |
24 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
138 |
138 |
$0.00 |
| 3044F |
|
88 |
78 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
100 |
100 |
$0.00 |
| D2331 |
|
30 |
22 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
56 |
48 |
$0.00 |
| D0602 |
|
27 |
27 |
$0.00 |
| D1330 |
|
275 |
274 |
$0.00 |
| D5899 |
|
64 |
48 |
$0.00 |
| 87428 |
|
31 |
31 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
15 |
15 |
$0.00 |
| 90732 |
|
12 |
12 |
$0.00 |
| 90648 |
|
193 |
192 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
373 |
344 |
$0.00 |
| 3077F |
|
327 |
312 |
$0.00 |
| 90734 |
|
657 |
656 |
$0.00 |
| 90700 |
|
530 |
528 |
$0.00 |
| D0330 |
Panoramic radiographic image |
27 |
27 |
$0.00 |
| 99173 |
|
921 |
919 |
$0.00 |
| 90710 |
|
689 |
687 |
$0.00 |
| 90671 |
|
34 |
34 |
$0.00 |
| 90707 |
|
376 |
374 |
$0.00 |
| 3078F |
|
670 |
629 |
$0.00 |
| D1110 |
Prophylaxis - adult |
773 |
723 |
$0.00 |
| D1120 |
Prophylaxis - child |
66 |
66 |
$0.00 |
| 92552 |
|
241 |
241 |
$0.00 |
| 90685 |
|
83 |
83 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
128 |
128 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
230 |
227 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
26 |
24 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
71 |
51 |
$0.00 |
| D0270 |
|
20 |
20 |
$0.00 |