| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
194,353 |
177,516 |
$28.83M |
| D9450 |
|
52,003 |
34,539 |
$1.60M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
8,527 |
8,366 |
$1.21M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
6,646 |
6,495 |
$976K |
| 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 |
30,695 |
26,236 |
$961K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
4,995 |
4,973 |
$660K |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
4,611 |
3,163 |
$636K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,636 |
4,508 |
$621K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
21,173 |
20,980 |
$478K |
| D1110 |
Prophylaxis - adult |
16,965 |
13,022 |
$434K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,184 |
3,108 |
$409K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
52,044 |
48,616 |
$283K |
| 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 |
1,397 |
1,285 |
$268K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
25,282 |
24,590 |
$256K |
| 99188 |
|
9,619 |
9,577 |
$243K |
| D7140 |
Extraction, erupted tooth or exposed root |
5,389 |
2,002 |
$241K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16,474 |
16,172 |
$204K |
| D1120 |
Prophylaxis - child |
3,782 |
3,699 |
$191K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
27,924 |
26,940 |
$188K |
| 99401 |
|
6,543 |
6,198 |
$184K |
| D0140 |
Limited oral evaluation - problem focused |
7,350 |
4,403 |
$178K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
7,654 |
7,222 |
$177K |
| D0120 |
Periodic oral evaluation - established patient |
11,716 |
9,304 |
$159K |
| 99173 |
|
10,124 |
9,854 |
$150K |
| D0210 |
Intraoral - complete series of radiographic images |
4,916 |
3,755 |
$149K |
| 99050 |
|
4,217 |
4,155 |
$149K |
| D1206 |
Topical application of fluoride varnish |
6,103 |
5,876 |
$141K |
| D0274 |
Bitewings - four radiographic images |
6,540 |
5,205 |
$133K |
| 90686 |
|
11,517 |
11,095 |
$127K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,792 |
1,772 |
$122K |
| 99381 |
|
627 |
625 |
$117K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,714 |
1,709 |
$102K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
2,742 |
1,809 |
$98K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
5,242 |
4,735 |
$85K |
| 92551 |
|
8,041 |
7,775 |
$76K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,024 |
1,299 |
$76K |
| 97802 |
|
1,408 |
1,400 |
$74K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,477 |
2,065 |
$70K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
2,467 |
2,414 |
$69K |
| 90834 |
Psychotherapy, 45 minutes with patient |
805 |
601 |
$69K |
| 97803 |
|
1,619 |
1,590 |
$66K |
| 90746 |
|
957 |
952 |
$63K |
| 90739 |
|
341 |
338 |
$54K |
| 90715 |
|
1,843 |
1,829 |
$51K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
526 |
261 |
$50K |
| D0330 |
Panoramic radiographic image |
1,213 |
807 |
$49K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
962 |
947 |
$48K |
| D0220 |
Intraoral - periapical first radiographic image |
5,301 |
3,209 |
$48K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
844 |
627 |
$48K |
| 83655 |
|
4,254 |
4,141 |
$47K |
| D2140 |
|
1,653 |
943 |
$44K |
| D4341 |
|
1,488 |
587 |
$44K |
| 90750 |
|
359 |
359 |
$42K |
| T1502 |
Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit |
654 |
180 |
$39K |
| 90671 |
|
419 |
414 |
$38K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,268 |
3,216 |
$37K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,419 |
6,168 |
$36K |
| 90832 |
Psychotherapy, 30 minutes with patient |
915 |
644 |
$35K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,109 |
2,974 |
$34K |
| 98966 |
|
3,472 |
3,170 |
$34K |
| 90651 |
|
715 |
714 |
$33K |
| 91320 |
|
309 |
309 |
$33K |
| 84703 |
|
4,609 |
4,459 |
$30K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,801 |
3,639 |
$28K |
| 96127 |
|
2,651 |
2,624 |
$26K |
| 93000 |
|
1,846 |
1,809 |
$23K |
| D0272 |
Bitewings - two radiographic images |
776 |
732 |
$21K |
| D2331 |
|
569 |
311 |
$21K |
| 99402 |
|
429 |
348 |
$21K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
405 |
399 |
$21K |
| 81025 |
|
2,378 |
2,274 |
$18K |
| D1351 |
Sealant - per tooth |
430 |
131 |
$17K |
| D2160 |
|
447 |
296 |
$16K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,915 |
1,901 |
$16K |
| 81002 |
|
6,325 |
6,170 |
$15K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
135 |
126 |
$12K |
| 90632 |
|
176 |
175 |
$11K |
| 90837 |
Psychotherapy, 53 minutes with patient |
113 |
90 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,579 |
5,343 |
$9K |
| G0299 |
Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes |
120 |
93 |
$9K |
| D9110 |
|
333 |
193 |
$8K |
| 90480 |
|
216 |
215 |
$7K |
| D2330 |
|
231 |
111 |
$7K |
| 90674 |
|
1,223 |
1,215 |
$7K |
| D2332 |
|
133 |
83 |
$6K |
| 90732 |
|
150 |
149 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,047 |
2,911 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
550 |
275 |
$4K |
| 98967 |
|
250 |
237 |
$4K |
| H2015 |
Comprehensive community support services, per 15 minutes |
35 |
32 |
$4K |
| 90734 |
|
237 |
234 |
$3K |
| 0012A |
|
66 |
66 |
$3K |
| 0011A |
|
114 |
113 |
$3K |
| 99442 |
|
126 |
124 |
$2K |
| 90707 |
|
270 |
270 |
$2K |
| 81003 |
|
1,062 |
1,026 |
$2K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
74 |
74 |
$2K |
| 91322 |
|
12 |
12 |
$2K |
| 92558 |
|
347 |
346 |
$2K |
| 82947 |
|
469 |
458 |
$2K |
| 90670 |
|
613 |
610 |
$1K |
| 90662 |
|
400 |
397 |
$1K |
| 90887 |
|
82 |
70 |
$1K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
29 |
27 |
$1K |
| 98968 |
|
40 |
40 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
76 |
76 |
$1K |
| 0124A |
|
20 |
20 |
$917.40 |
| 90658 |
|
253 |
252 |
$769.60 |
| G0136 |
Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months |
1,118 |
1,110 |
$740.28 |
| 0001A |
|
16 |
16 |
$734.08 |
| D2335 |
|
14 |
12 |
$730.00 |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
12 |
12 |
$656.60 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
12 |
12 |
$616.80 |
| 82948 |
|
202 |
202 |
$595.04 |
| 92015 |
Determination of refractive state |
39 |
39 |
$561.21 |
| 90461 |
|
1,987 |
1,979 |
$403.44 |
| 91301 |
|
1,953 |
1,861 |
$305.29 |
| 90649 |
|
361 |
361 |
$300.83 |
| 0013A |
|
53 |
50 |
$294.23 |
| 86701 |
|
42 |
42 |
$288.58 |
| 99441 |
|
26 |
26 |
$280.02 |
| G0008 |
Administration of influenza virus vaccine |
2,332 |
2,312 |
$273.61 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
2,999 |
2,976 |
$265.07 |
| 94760 |
|
387 |
368 |
$186.05 |
| 94664 |
|
13 |
13 |
$184.78 |
| 88720 |
|
39 |
29 |
$172.77 |
| 90710 |
|
151 |
150 |
$162.10 |
| D0270 |
|
20 |
12 |
$121.00 |
| 90713 |
|
14 |
14 |
$112.56 |
| 11719 |
|
12 |
12 |
$91.22 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
3,061 |
3,039 |
$90.24 |
| 90620 |
|
235 |
235 |
$34.21 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
23 |
21 |
$29.73 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
386 |
373 |
$19.46 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
547 |
533 |
$12.32 |
| 0064A |
|
83 |
83 |
$0.00 |
| 90619 |
|
526 |
525 |
$0.00 |
| 90680 |
|
898 |
895 |
$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 |
62 |
58 |
$0.00 |
| 90677 |
|
679 |
678 |
$0.00 |
| 90698 |
|
679 |
672 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
395 |
393 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
122 |
115 |
$0.00 |
| 99172 |
|
469 |
468 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
12 |
12 |
$0.00 |
| 90697 |
|
699 |
697 |
$0.00 |
| 91303 |
|
146 |
145 |
$0.00 |
| 90716 |
|
232 |
231 |
$0.00 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
17 |
13 |
$0.00 |
| 36416 |
|
457 |
446 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
270 |
269 |
$0.00 |
| 91305 |
|
88 |
86 |
$0.00 |
| V5008 |
Hearing screening |
2,532 |
2,519 |
$0.00 |
| 90696 |
|
95 |
93 |
$0.00 |
| 90744 |
|
174 |
174 |
$0.00 |
| 96380 |
|
17 |
17 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| 2010F |
|
28 |
26 |
$0.00 |
| 90633 |
|
1,128 |
1,123 |
$0.00 |
| D1999 |
|
15,111 |
8,254 |
$0.00 |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
66 |
63 |
$0.00 |
| 91312 |
|
113 |
112 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
289 |
286 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
12 |
12 |
$0.00 |
| 91311 |
|
75 |
75 |
$0.00 |
| G9920 |
Screening performed and negative |
548 |
543 |
$0.00 |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
12 |
12 |
$0.00 |
| 90691 |
|
28 |
28 |
$0.00 |
| 90473 |
|
30 |
29 |
$0.00 |
| 91300 |
|
660 |
605 |
$0.00 |
| 96160 |
|
40 |
40 |
$0.00 |
| 90661 |
|
345 |
345 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
12 |
12 |
$0.00 |