| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
70,069 |
55,887 |
$9.91M |
| 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 |
15,092 |
12,595 |
$2.23M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
15,726 |
9,189 |
$2.00M |
| 90834 |
Psychotherapy, 45 minutes with patient |
27,005 |
13,607 |
$1.99M |
| D9450 |
|
43,993 |
25,051 |
$1.40M |
| D1110 |
Prophylaxis - adult |
18,013 |
11,860 |
$483K |
| D2740 |
Crown - porcelain/ceramic |
946 |
659 |
$464K |
| 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 |
11,566 |
9,106 |
$400K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,710 |
2,696 |
$386K |
| D0210 |
Intraoral - complete series of radiographic images |
5,112 |
3,415 |
$191K |
| D0120 |
Periodic oral evaluation - established patient |
15,066 |
10,006 |
$172K |
| 90791 |
Psychiatric diagnostic evaluation |
1,371 |
1,352 |
$163K |
| D0140 |
Limited oral evaluation - problem focused |
6,368 |
3,939 |
$151K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
4,128 |
2,302 |
$144K |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,304 |
2,648 |
$141K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,503 |
6,825 |
$131K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
8,701 |
5,826 |
$128K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,540 |
3,531 |
$127K |
| D0274 |
Bitewings - four radiographic images |
6,399 |
4,271 |
$118K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
3,688 |
1,523 |
$112K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,637 |
2,565 |
$105K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
3,673 |
1,843 |
$102K |
| 90682 |
|
1,701 |
1,692 |
$100K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,905 |
6,079 |
$93K |
| 91322 |
|
594 |
584 |
$83K |
| 90651 |
|
695 |
687 |
$82K |
| D9110 |
|
3,828 |
2,079 |
$75K |
| D0220 |
Intraoral - periapical first radiographic image |
7,360 |
4,486 |
$64K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,094 |
2,059 |
$60K |
| 90750 |
|
426 |
422 |
$60K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
751 |
750 |
$57K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,273 |
9,009 |
$57K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
791 |
789 |
$53K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
1,404 |
742 |
$52K |
| 92015 |
Determination of refractive state |
4,145 |
4,057 |
$49K |
| D2950 |
|
463 |
308 |
$48K |
| 90686 |
|
2,530 |
2,514 |
$46K |
| D7140 |
Extraction, erupted tooth or exposed root |
936 |
309 |
$43K |
| 90715 |
|
1,085 |
1,074 |
$35K |
| 92310 |
|
356 |
354 |
$33K |
| 97810 |
|
1,441 |
553 |
$33K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,773 |
2,959 |
$32K |
| 99050 |
|
562 |
542 |
$29K |
| 90480 |
|
542 |
531 |
$24K |
| D0270 |
|
3,195 |
2,090 |
$22K |
| 92250 |
|
1,161 |
1,070 |
$18K |
| 90677 |
|
78 |
76 |
$18K |
| D2751 |
Crown - porcelain fused to predominantly base metal |
59 |
30 |
$17K |
| D4341 |
|
1,131 |
306 |
$16K |
| 92341 |
|
458 |
457 |
$16K |
| D2331 |
|
288 |
167 |
$15K |
| 90732 |
|
156 |
154 |
$11K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,201 |
646 |
$9K |
| 0011A |
|
222 |
222 |
$9K |
| 0134A |
|
198 |
196 |
$9K |
| D0180 |
|
231 |
226 |
$7K |
| 0012A |
|
138 |
138 |
$6K |
| 90739 |
|
52 |
51 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,728 |
1,642 |
$6K |
| D2332 |
|
101 |
37 |
$5K |
| D2330 |
|
87 |
62 |
$5K |
| 97811 |
|
153 |
74 |
$5K |
| D2335 |
|
84 |
38 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
204 |
202 |
$3K |
| 99385 |
|
29 |
29 |
$3K |
| 90673 |
|
53 |
53 |
$3K |
| 93000 |
|
185 |
183 |
$3K |
| 81025 |
|
392 |
378 |
$2K |
| D0330 |
Panoramic radiographic image |
50 |
41 |
$2K |
| 90746 |
|
37 |
37 |
$2K |
| 90734 |
|
26 |
26 |
$2K |
| 81003 |
|
1,050 |
879 |
$2K |
| 99215 |
Prolong outpt/office vis |
98 |
93 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
26 |
26 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
77 |
76 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
116 |
114 |
$1K |
| D2394 |
|
25 |
12 |
$1K |
| 90649 |
|
14 |
14 |
$1K |
| 90630 |
|
61 |
60 |
$996.66 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
47 |
39 |
$990.84 |
| 0064A |
|
20 |
20 |
$825.66 |
| 90632 |
|
13 |
13 |
$778.83 |
| D1206 |
Topical application of fluoride varnish |
29 |
28 |
$696.00 |
| 97026 |
|
65 |
32 |
$674.35 |
| 0124A |
|
14 |
14 |
$642.18 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
64 |
64 |
$534.09 |
| 0004A |
|
12 |
12 |
$504.57 |
| 90656 |
|
16 |
16 |
$265.80 |
| 99443 |
|
78 |
72 |
$212.73 |
| D1354 |
|
19 |
12 |
$210.00 |
| 92370 |
|
23 |
17 |
$201.42 |
| 99442 |
|
40 |
38 |
$166.48 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
14 |
14 |
$113.96 |
| 81002 |
|
29 |
24 |
$85.96 |
| 86580 |
|
12 |
12 |
$72.48 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
16 |
16 |
$41.38 |
| J1380 |
Injection, estradiol valerate, up to 10 mg |
378 |
207 |
$14.53 |
| J1071 |
Injection, testosterone cypionate, 1 mg |
1,114 |
613 |
$7.83 |
| D9995 |
|
390 |
193 |
$0.00 |
| Q9992 |
Injection, buprenorphine extended-release (sublocade), greater than 100 mg |
116 |
114 |
$0.00 |
| D1330 |
|
863 |
588 |
$0.00 |
| 11980 |
|
68 |
68 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
571 |
558 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
45 |
44 |
$0.00 |
| 91306 |
|
401 |
400 |
$0.00 |
| 91301 |
|
1,440 |
1,399 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
42 |
42 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
75 |
75 |
$0.00 |
| 91303 |
|
13 |
13 |
$0.00 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
12 |
12 |
$0.00 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
183 |
181 |
$0.00 |
| 91313 |
|
85 |
83 |
$0.00 |
| 90679 |
|
13 |
13 |
$0.00 |
| 91300 |
|
194 |
194 |
$0.00 |
| 90611 |
|
454 |
439 |
$0.00 |
| 90749 |
|
87 |
87 |
$0.00 |
| D9944 |
|
14 |
12 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
15 |
15 |
$0.00 |
| 46607 |
|
12 |
12 |
$0.00 |
| 99051 |
|
13 |
12 |
$0.00 |
| D9996 |
|
24 |
13 |
$0.00 |
| 46601 |
|
12 |
12 |
$0.00 |