| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
89,331 |
57,453 |
$16.11M |
| T1016 |
Case management, each 15 minutes |
8,412 |
6,931 |
$137K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,862 |
16,473 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13,683 |
10,735 |
$5K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
17,683 |
8,434 |
$3K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,182 |
1,038 |
$3K |
| H0031 |
Mental health assessment, by non-physician |
2,127 |
1,926 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
891 |
778 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,017 |
847 |
$886.93 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,424 |
4,802 |
$761.47 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,365 |
1,232 |
$694.44 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
612 |
536 |
$538.68 |
| 96156 |
|
1,506 |
1,211 |
$531.88 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,300 |
1,122 |
$461.80 |
| 97802 |
|
2,773 |
2,329 |
$451.54 |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,948 |
2,109 |
$415.80 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,376 |
2,134 |
$347.23 |
| 0071A |
|
117 |
99 |
$234.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
311 |
307 |
$231.50 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
434 |
375 |
$211.98 |
| 0072A |
|
167 |
136 |
$156.00 |
| 90791 |
Psychiatric diagnostic evaluation |
630 |
518 |
$119.09 |
| 0001A |
|
75 |
65 |
$104.00 |
| 90474 |
|
205 |
197 |
$85.32 |
| 0064A |
|
59 |
51 |
$83.00 |
| 90686 |
|
1,632 |
1,438 |
$71.69 |
| 97803 |
|
1,488 |
1,200 |
$65.28 |
| 90832 |
Psychotherapy, 30 minutes with patient |
409 |
282 |
$59.62 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
667 |
593 |
$32.37 |
| 99443 |
|
31 |
25 |
$31.24 |
| 99442 |
|
201 |
148 |
$21.30 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
42 |
39 |
$14.51 |
| 99441 |
|
86 |
58 |
$10.79 |
| 81002 |
|
116 |
107 |
$6.96 |
| 0054A |
|
81 |
68 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
537 |
440 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
952 |
905 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
347 |
212 |
$0.00 |
| 1160F |
|
2,679 |
2,477 |
$0.00 |
| 90633 |
|
70 |
57 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
217 |
131 |
$0.00 |
| 4274F |
|
1,476 |
1,307 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
180 |
155 |
$0.00 |
| 90670 |
|
248 |
233 |
$0.00 |
| 81025 |
|
86 |
77 |
$0.00 |
| 90715 |
|
120 |
109 |
$0.00 |
| 3078F |
|
1,940 |
1,833 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
75 |
73 |
$0.00 |
| 1159F |
|
2,677 |
2,474 |
$0.00 |
| D1354 |
|
139 |
24 |
$0.00 |
| D0190 |
|
1,962 |
1,940 |
$0.00 |
| 4040F |
|
747 |
624 |
$0.00 |
| 0124A |
|
74 |
68 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
536 |
246 |
$0.00 |
| 99001 |
|
76 |
71 |
$0.00 |
| D0270 |
|
173 |
168 |
$0.00 |
| 3077F |
|
77 |
71 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
103 |
103 |
$0.00 |
| D1120 |
Prophylaxis - child |
371 |
362 |
$0.00 |
| D1321 |
|
55 |
55 |
$0.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
101 |
99 |
$0.00 |
| 0004A |
|
26 |
19 |
$0.00 |
| 0002A |
|
29 |
28 |
$0.00 |
| D0330 |
Panoramic radiographic image |
39 |
38 |
$0.00 |
| 90630 |
|
18 |
14 |
$0.00 |
| 96160 |
|
25 |
25 |
$0.00 |
| 91320 |
|
52 |
34 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
651 |
573 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
1,191 |
1,129 |
$0.00 |
| 1036F |
|
3,632 |
3,278 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
152 |
150 |
$0.00 |
| 3079F |
|
627 |
608 |
$0.00 |
| D1330 |
|
44 |
42 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
52 |
52 |
$0.00 |
| D1320 |
|
89 |
88 |
$0.00 |
| 96127 |
|
267 |
260 |
$0.00 |
| 3074F |
|
2,245 |
2,104 |
$0.00 |
| 90680 |
|
209 |
156 |
$0.00 |
| 3008F |
|
3,433 |
3,163 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
411 |
349 |
$0.00 |
| 3351F |
|
1,015 |
974 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
106 |
62 |
$0.00 |
| 87428 |
|
253 |
217 |
$0.00 |
| 3075F |
|
198 |
192 |
$0.00 |
| 2010F |
|
3,498 |
3,219 |
$0.00 |
| 90698 |
|
142 |
130 |
$0.00 |
| D1310 |
|
43 |
41 |
$0.00 |
| 2001F |
|
3,459 |
3,185 |
$0.00 |
| 1126F |
|
610 |
602 |
$0.00 |
| 96150 |
|
544 |
387 |
$0.00 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
134 |
107 |
$0.00 |
| 99381 |
|
41 |
39 |
$0.00 |
| 90480 |
|
39 |
29 |
$0.00 |
| 1034F |
|
205 |
189 |
$0.00 |
| 90656 |
|
189 |
111 |
$0.00 |
| D9995 |
|
157 |
151 |
$0.00 |
| 2000F |
|
2,711 |
2,536 |
$0.00 |
| 99383 |
|
14 |
14 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
56 |
45 |
$0.00 |
| 99174 |
|
78 |
56 |
$0.00 |
| 4037F |
|
310 |
306 |
$0.00 |
| 0012A |
|
124 |
123 |
$0.00 |
| 1125F |
|
71 |
64 |
$0.00 |
| 3080F |
|
13 |
13 |
$0.00 |
| 90651 |
|
91 |
81 |
$0.00 |
| 90697 |
|
12 |
12 |
$0.00 |
| 4010F |
|
38 |
36 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
22 |
22 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
38 |
38 |
$0.00 |
| 0011A |
|
144 |
136 |
$0.00 |