| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
39,623 |
34,189 |
$8.76M |
| D0999 |
Unspecified diagnostic procedure, by report |
5,057 |
4,586 |
$1.50M |
| 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 |
981 |
717 |
$96K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,834 |
7,706 |
$37K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27,429 |
23,974 |
$35K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
523 |
512 |
$22K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,539 |
2,515 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,540 |
1,384 |
$7K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
184 |
180 |
$7K |
| 0002A |
|
160 |
159 |
$5K |
| 0001A |
|
180 |
180 |
$5K |
| 90473 |
|
286 |
286 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,947 |
1,652 |
$2K |
| 90686 |
|
2,652 |
2,627 |
$2K |
| 90474 |
|
498 |
496 |
$1K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
442 |
310 |
$771.30 |
| 2001F |
|
8,467 |
7,629 |
$273.62 |
| 36415 |
Collection of venous blood by venipuncture |
206 |
197 |
$209.86 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
274 |
268 |
$175.11 |
| 90656 |
|
253 |
253 |
$160.11 |
| 90670 |
|
641 |
634 |
$155.58 |
| 90672 |
|
482 |
481 |
$129.43 |
| 3078F |
|
5,185 |
4,803 |
$50.87 |
| 3074F |
|
6,186 |
5,665 |
$50.86 |
| 80305 |
|
709 |
594 |
$39.02 |
| 90715 |
|
49 |
48 |
$27.86 |
| 90674 |
|
62 |
62 |
$21.05 |
| D1110 |
Prophylaxis - adult |
829 |
817 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
613 |
613 |
$0.00 |
| D1120 |
Prophylaxis - child |
660 |
660 |
$0.00 |
| D0330 |
Panoramic radiographic image |
340 |
340 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
351 |
348 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,116 |
1,108 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
70 |
66 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
2,669 |
2,431 |
$0.00 |
| 1159F |
|
5,449 |
4,888 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
364 |
359 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,106 |
1,075 |
$0.00 |
| 4004F |
|
1,178 |
1,039 |
$0.00 |
| 91300 |
|
422 |
395 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
61 |
38 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
40 |
40 |
$0.00 |
| 90734 |
|
66 |
66 |
$0.00 |
| 90633 |
|
116 |
112 |
$0.00 |
| 3077F |
|
98 |
93 |
$0.00 |
| 90687 |
|
104 |
101 |
$0.00 |
| D0270 |
|
13 |
13 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
214 |
213 |
$0.00 |
| 90685 |
|
24 |
22 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 86703 |
|
54 |
54 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
1,237 |
1,237 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
125 |
125 |
$0.00 |
| 90697 |
|
185 |
185 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
1,377 |
1,370 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
2,747 |
2,493 |
$0.00 |
| 3079F |
|
1,967 |
1,820 |
$0.00 |
| 90677 |
|
251 |
250 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
241 |
149 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
176 |
176 |
$0.00 |
| 1111F |
|
1,201 |
1,114 |
$0.00 |
| 90723 |
|
246 |
245 |
$0.00 |
| 90680 |
|
311 |
310 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
376 |
372 |
$0.00 |
| 3075F |
|
407 |
394 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
125 |
125 |
$0.00 |
| 91307 |
|
14 |
13 |
$0.00 |
| 90651 |
|
107 |
102 |
$0.00 |
| 90660 |
|
30 |
30 |
$0.00 |
| 90647 |
|
175 |
171 |
$0.00 |
| 86803 |
|
52 |
52 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
29 |
15 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
13 |
12 |
$0.00 |
| 90716 |
|
24 |
24 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
15 |
15 |
$0.00 |