| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
34,047 |
26,396 |
$2.16M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13,597 |
7,995 |
$427K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,385 |
8,114 |
$280K |
| D7140 |
Extraction, erupted tooth or exposed root |
5,160 |
2,098 |
$138K |
| D0330 |
Panoramic radiographic image |
5,261 |
3,605 |
$99K |
| D1110 |
Prophylaxis - adult |
6,265 |
4,375 |
$85K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,434 |
795 |
$65K |
| D0140 |
Limited oral evaluation - problem focused |
4,963 |
3,366 |
$50K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
5,235 |
3,608 |
$50K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,099 |
1,106 |
$47K |
| D0120 |
Periodic oral evaluation - established patient |
4,799 |
3,246 |
$39K |
| D1120 |
Prophylaxis - child |
4,017 |
2,637 |
$37K |
| D1206 |
Topical application of fluoride varnish |
5,200 |
3,432 |
$35K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,437 |
744 |
$33K |
| D0274 |
Bitewings - four radiographic images |
2,038 |
1,409 |
$18K |
| 90837 |
Psychotherapy, 53 minutes with patient |
472 |
191 |
$18K |
| 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 |
1,275 |
1,089 |
$15K |
| 90832 |
Psychotherapy, 30 minutes with patient |
451 |
203 |
$13K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
577 |
387 |
$13K |
| 90834 |
Psychotherapy, 45 minutes with patient |
396 |
178 |
$11K |
| D0220 |
Intraoral - periapical first radiographic image |
4,265 |
2,915 |
$9K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
309 |
180 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
566 |
409 |
$5K |
| 80305 |
|
667 |
420 |
$4K |
| 99441 |
|
605 |
301 |
$3K |
| 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 |
327 |
296 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,590 |
527 |
$3K |
| 99442 |
|
199 |
97 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
29 |
14 |
$1K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
22 |
19 |
$1K |
| 99215 |
Prolong outpt/office vis |
26 |
13 |
$1K |
| D0272 |
Bitewings - two radiographic images |
207 |
132 |
$1K |
| 81025 |
|
225 |
165 |
$1K |
| 36416 |
|
1,309 |
897 |
$855.81 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
181 |
70 |
$812.83 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
272 |
201 |
$790.95 |
| 99406 |
|
572 |
364 |
$754.96 |
| D1351 |
Sealant - per tooth |
75 |
14 |
$739.20 |
| H0048 |
Alcohol and/or other drug testing: collection and handling only, specimens other than blood |
545 |
356 |
$690.07 |
| 90686 |
|
98 |
61 |
$625.21 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
27 |
17 |
$605.70 |
| D2331 |
|
23 |
12 |
$599.94 |
| 82962 |
|
555 |
397 |
$564.90 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
37 |
28 |
$540.97 |
| D0210 |
Intraoral - complete series of radiographic images |
93 |
63 |
$360.00 |
| 90756 |
|
29 |
16 |
$305.39 |
| 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 |
43 |
37 |
$149.30 |
| D0270 |
|
79 |
54 |
$115.50 |
| 90863 |
|
151 |
76 |
$63.98 |
| 82044 |
|
61 |
45 |
$46.70 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
14 |
$39.28 |
| 81002 |
|
69 |
49 |
$36.93 |
| H0036 |
Community psychiatric supportive treatment, face-to-face, per 15 minutes |
17 |
12 |
$33.60 |
| 99408 |
|
627 |
403 |
$27.44 |
| 3078F |
|
8,286 |
4,306 |
$0.05 |
| 3075F |
|
1,542 |
801 |
$0.04 |
| 3074F |
|
10,093 |
5,214 |
$0.03 |
| 3079F |
|
4,833 |
2,546 |
$0.02 |
| 1159F |
|
248 |
240 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
1,015 |
484 |
$0.00 |
| D1999 |
|
1,162 |
864 |
$0.00 |
| 3077F |
|
660 |
344 |
$0.00 |
| 1160F |
|
248 |
240 |
$0.00 |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
431 |
316 |
$0.00 |
| 4004F |
|
38 |
16 |
$0.00 |
| 1036F |
|
2,767 |
1,359 |
$0.00 |
| 3044F |
|
38 |
25 |
$0.00 |
| 0001F |
|
5,348 |
2,662 |
$0.00 |
| 1000F |
|
1,396 |
686 |
$0.00 |
| D0603 |
|
719 |
553 |
$0.00 |
| 4000F |
|
1,102 |
546 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
115 |
99 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
343 |
157 |
$0.00 |
| 3080F |
|
151 |
82 |
$0.00 |
| G8756 |
No documentation of blood pressure measurement, reason not given |
24 |
13 |
$0.00 |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
21 |
14 |
$0.00 |