| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
66,400 |
55,418 |
$15.46M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26,611 |
21,967 |
$1.15M |
| D0999 |
Unspecified diagnostic procedure, by report |
2,314 |
2,106 |
$603K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,736 |
7,831 |
$403K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,763 |
1,704 |
$199K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,620 |
2,529 |
$187K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,601 |
2,560 |
$153K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,206 |
2,160 |
$133K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
681 |
670 |
$128K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
972 |
939 |
$66K |
| 99381 |
|
318 |
310 |
$61K |
| 99384 |
|
342 |
336 |
$43K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,162 |
840 |
$37K |
| 99385 |
|
163 |
157 |
$35K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
54 |
54 |
$30K |
| 99383 |
|
151 |
148 |
$20K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
324 |
309 |
$11K |
| 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 |
276 |
265 |
$9K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
26 |
26 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
27,193 |
12,315 |
$3K |
| 97169 |
|
95 |
95 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,551 |
4,261 |
$1K |
| 81025 |
|
2,177 |
2,065 |
$614.55 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,111 |
4,004 |
$544.84 |
| 81002 |
|
4,924 |
3,666 |
$433.51 |
| 90686 |
|
3,470 |
3,437 |
$226.20 |
| D0120 |
Periodic oral evaluation - established patient |
604 |
580 |
$115.40 |
| D1206 |
Topical application of fluoride varnish |
1,005 |
966 |
$102.90 |
| 90461 |
|
1,851 |
1,572 |
$41.83 |
| D0220 |
Intraoral - periapical first radiographic image |
1,788 |
1,075 |
$37.68 |
| D1120 |
Prophylaxis - child |
678 |
654 |
$36.75 |
| D0274 |
Bitewings - four radiographic images |
441 |
433 |
$34.61 |
| 92551 |
|
5,543 |
5,447 |
$30.05 |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,094 |
770 |
$23.47 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
416 |
401 |
$13.75 |
| 1159F |
|
1,405 |
1,215 |
$0.00 |
| 96160 |
|
613 |
602 |
$0.00 |
| 3078F |
|
1,053 |
901 |
$0.00 |
| 99173 |
|
5,429 |
5,315 |
$0.00 |
| 90649 |
|
267 |
262 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
43 |
37 |
$0.00 |
| D0330 |
Panoramic radiographic image |
131 |
127 |
$0.00 |
| 92015 |
Determination of refractive state |
145 |
83 |
$0.00 |
| 0502F |
|
112 |
73 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
26 |
26 |
$0.00 |
| 90658 |
|
39 |
37 |
$0.00 |
| 90715 |
|
13 |
12 |
$0.00 |
| 3077F |
|
19 |
15 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
14 |
$0.00 |
| 82962 |
|
830 |
771 |
$0.00 |
| D0603 |
|
753 |
710 |
$0.00 |
| 3074F |
|
1,115 |
940 |
$0.00 |
| 3008F |
|
1,353 |
1,140 |
$0.00 |
| 2001F |
|
1,352 |
1,139 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
37 |
37 |
$0.00 |
| 90688 |
|
70 |
70 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
27 |
27 |
$0.00 |
| 1036F |
|
364 |
316 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
14 |
13 |
$0.00 |
| D0602 |
|
96 |
96 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
43 |
41 |
$0.00 |
| 3079F |
|
82 |
74 |
$0.00 |