| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
51,403 |
37,961 |
$8.51M |
| D0999 |
Unspecified diagnostic procedure, by report |
4,282 |
3,594 |
$927K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27,498 |
21,641 |
$841K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,721 |
6,093 |
$273K |
| 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 |
5,424 |
4,794 |
$186K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,658 |
2,611 |
$157K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,946 |
7,249 |
$137K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,072 |
1,999 |
$116K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,322 |
1,311 |
$81K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
968 |
955 |
$63K |
| CP002 |
|
4,664 |
4,088 |
$46K |
| 59430 |
|
624 |
548 |
$37K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,562 |
1,394 |
$20K |
| 99381 |
|
361 |
348 |
$19K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
486 |
421 |
$16K |
| 99463 |
|
133 |
132 |
$12K |
| 99000 |
|
3,234 |
2,930 |
$12K |
| 90837 |
Psychotherapy, 53 minutes with patient |
128 |
98 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
267 |
255 |
$11K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
331 |
323 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
129 |
120 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,053 |
1,009 |
$6K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
447 |
435 |
$4K |
| 0071A |
|
161 |
102 |
$4K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
166 |
129 |
$3K |
| 81003 |
|
2,826 |
1,746 |
$2K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
25 |
23 |
$2K |
| 99460 |
|
24 |
24 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
90 |
87 |
$2K |
| D0330 |
Panoramic radiographic image |
472 |
448 |
$1K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
153 |
148 |
$1K |
| 87210 |
|
542 |
512 |
$1K |
| 0072A |
|
103 |
86 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
1,548 |
1,490 |
$1K |
| 99215 |
Prolong outpt/office vis |
39 |
37 |
$1K |
| 81025 |
|
149 |
144 |
$822.27 |
| D0274 |
Bitewings - four radiographic images |
338 |
320 |
$686.05 |
| 99201 |
|
14 |
14 |
$541.74 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
723 |
499 |
$531.67 |
| 81001 |
|
458 |
435 |
$521.04 |
| 99384 |
|
12 |
12 |
$502.15 |
| 99441 |
|
914 |
843 |
$473.30 |
| D1110 |
Prophylaxis - adult |
311 |
309 |
$470.95 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,322 |
1,200 |
$440.76 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
149 |
140 |
$432.32 |
| A4267 |
Contraceptive supply, condom, male, each |
46 |
43 |
$415.26 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
401 |
382 |
$404.95 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
33 |
29 |
$402.35 |
| 0004A |
|
12 |
12 |
$280.00 |
| D0140 |
Limited oral evaluation - problem focused |
53 |
52 |
$265.70 |
| 99442 |
|
207 |
202 |
$263.36 |
| D0120 |
Periodic oral evaluation - established patient |
886 |
873 |
$233.88 |
| 90648 |
|
856 |
856 |
$226.34 |
| D1208 |
Topical application of fluoride, excluding varnish |
1,485 |
1,471 |
$218.53 |
| 90621 |
|
13 |
13 |
$178.38 |
| 73630 |
|
34 |
14 |
$159.61 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12 |
12 |
$147.40 |
| 81002 |
|
352 |
301 |
$128.48 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
69 |
65 |
$111.73 |
| 90686 |
|
808 |
804 |
$109.14 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,100 |
2,084 |
$55.00 |
| D1120 |
Prophylaxis - child |
927 |
920 |
$49.39 |
| 87220 |
|
52 |
44 |
$14.36 |
| 90651 |
|
251 |
249 |
$0.00 |
| 90474 |
|
91 |
90 |
$0.00 |
| 90680 |
|
199 |
199 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
2,463 |
2,250 |
$0.00 |
| D0601 |
|
15 |
15 |
$0.00 |
| D0603 |
|
1,181 |
1,151 |
$0.00 |
| D0602 |
|
397 |
396 |
$0.00 |
| 90677 |
|
530 |
526 |
$0.00 |
| 90723 |
|
516 |
516 |
$0.00 |
| 90698 |
|
254 |
252 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
519 |
512 |
$0.00 |
| D1351 |
Sealant - per tooth |
889 |
204 |
$0.00 |
| 90657 |
|
73 |
73 |
$0.00 |
| 91307 |
|
128 |
127 |
$0.00 |
| 0240U |
|
69 |
52 |
$0.00 |
| 90697 |
|
354 |
351 |
$0.00 |
| 90688 |
|
211 |
211 |
$0.00 |
| 90744 |
|
14 |
14 |
$0.00 |
| 90716 |
|
14 |
14 |
$0.00 |
| 90696 |
|
25 |
25 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
264 |
204 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
95 |
71 |
$0.00 |
| 99443 |
|
17 |
16 |
$0.00 |
| 0012A |
|
21 |
21 |
$0.00 |
| D1330 |
|
14 |
14 |
$0.00 |
| 90670 |
|
1,437 |
1,399 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,555 |
1,544 |
$0.00 |
| 90681 |
|
367 |
364 |
$0.00 |
| 90687 |
|
224 |
223 |
$0.00 |
| 90633 |
|
997 |
995 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
93 |
93 |
$0.00 |
| 90700 |
|
218 |
212 |
$0.00 |
| 90658 |
|
84 |
83 |
$0.00 |
| 90734 |
|
236 |
234 |
$0.00 |
| 90710 |
|
713 |
711 |
$0.00 |
| D1999 |
|
1,679 |
1,345 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
26 |
26 |
$0.00 |
| 91300 |
|
47 |
46 |
$0.00 |
| 90685 |
|
142 |
142 |
$0.00 |
| 90715 |
|
69 |
69 |
$0.00 |
| 90707 |
|
14 |
14 |
$0.00 |