| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
55,396 |
37,330 |
$3.06M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18,395 |
9,539 |
$443K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,452 |
11,336 |
$355K |
| D7140 |
Extraction, erupted tooth or exposed root |
7,783 |
2,430 |
$216K |
| D0330 |
Panoramic radiographic image |
9,180 |
5,185 |
$188K |
| D1110 |
Prophylaxis - adult |
7,969 |
4,580 |
$154K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
8,009 |
4,527 |
$119K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
3,694 |
1,787 |
$108K |
| D0120 |
Periodic oral evaluation - established patient |
8,615 |
4,903 |
$88K |
| D0274 |
Bitewings - four radiographic images |
9,188 |
5,313 |
$70K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,383 |
2,204 |
$51K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,390 |
702 |
$45K |
| D0140 |
Limited oral evaluation - problem focused |
3,546 |
1,809 |
$43K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,166 |
508 |
$42K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,307 |
649 |
$38K |
| 99406 |
|
11,626 |
5,458 |
$36K |
| D0210 |
Intraoral - complete series of radiographic images |
579 |
483 |
$30K |
| D1208 |
Topical application of fluoride, excluding varnish |
4,806 |
2,833 |
$27K |
| D1120 |
Prophylaxis - child |
1,247 |
735 |
$21K |
| 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 |
3,717 |
2,490 |
$20K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
829 |
415 |
$20K |
| D0220 |
Intraoral - periapical first radiographic image |
7,009 |
3,694 |
$17K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
2,452 |
1,185 |
$12K |
| 99385 |
|
381 |
186 |
$12K |
| 0011A |
|
376 |
246 |
$7K |
| 0012A |
|
303 |
204 |
$7K |
| 99215 |
Prolong outpt/office vis |
227 |
110 |
$7K |
| D0272 |
Bitewings - two radiographic images |
1,418 |
761 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,146 |
621 |
$6K |
| 90686 |
|
1,345 |
732 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
309 |
157 |
$5K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
226 |
114 |
$5K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
80 |
48 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
118 |
61 |
$4K |
| 97802 |
|
21,461 |
9,692 |
$3K |
| 0064A |
|
107 |
59 |
$3K |
| 96127 |
|
11,061 |
5,284 |
$3K |
| 90837 |
Psychotherapy, 53 minutes with patient |
55 |
40 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
614 |
175 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
172 |
86 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
52 |
31 |
$904.49 |
| 99386 |
|
27 |
12 |
$849.95 |
| D4341 |
|
29 |
13 |
$767.92 |
| 82962 |
|
745 |
378 |
$596.81 |
| 0031A |
|
49 |
13 |
$591.20 |
| D1351 |
Sealant - per tooth |
68 |
15 |
$528.00 |
| D1206 |
Topical application of fluoride varnish |
63 |
59 |
$435.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
47 |
30 |
$247.93 |
| 92250 |
|
50 |
28 |
$218.80 |
| 69210 |
|
21 |
12 |
$216.39 |
| 99443 |
|
13 |
13 |
$178.56 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
53 |
30 |
$164.79 |
| 36416 |
|
231 |
128 |
$122.99 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
558 |
272 |
$49.34 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
17,220 |
7,839 |
$44.64 |
| 3044F |
|
586 |
387 |
$40.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,590 |
755 |
$36.40 |
| 99173 |
|
25 |
12 |
$28.92 |
| S9470 |
Nutritional counseling, dietitian visit |
7,503 |
3,254 |
$26.64 |
| 81002 |
|
22 |
12 |
$13.05 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
11,387 |
5,346 |
$7.32 |
| 91301 |
|
655 |
439 |
$0.81 |
| 99071 |
|
10,020 |
5,062 |
$0.28 |
| 1000F |
|
41,937 |
20,871 |
$0.28 |
| 91303 |
|
33 |
13 |
$0.02 |
| G9276 |
Documentation that patient is a current tobacco user |
12,277 |
6,163 |
$0.00 |
| 80061 |
Lipid panel |
88 |
41 |
$0.00 |
| 3078F |
|
3,942 |
2,173 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
3,876 |
2,834 |
$0.00 |
| 2028F |
|
581 |
283 |
$0.00 |
| 3077F |
|
1,956 |
1,014 |
$0.00 |
| 98960 |
|
120 |
59 |
$0.00 |
| 96160 |
|
280 |
142 |
$0.00 |
| 1003F |
|
38 |
30 |
$0.00 |
| 3074F |
|
5,377 |
2,909 |
$0.00 |
| G9459 |
Currently a tobacco non-user |
14,820 |
7,462 |
$0.00 |
| 3008F |
|
32,387 |
15,847 |
$0.00 |
| 3080F |
|
1,266 |
640 |
$0.00 |
| 3075F |
|
2,139 |
1,199 |
$0.00 |
| 3079F |
|
4,208 |
2,248 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
18 |
17 |
$0.00 |