| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
13,692 |
10,658 |
$2.40M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
30,070 |
27,070 |
$488K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
20,641 |
18,475 |
$315K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
24,012 |
22,991 |
$254K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
10,830 |
10,377 |
$137K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,682 |
4,178 |
$97K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,913 |
3,800 |
$80K |
| D0120 |
Periodic oral evaluation - established patient |
4,941 |
4,911 |
$75K |
| D1206 |
Topical application of fluoride varnish |
4,317 |
4,283 |
$64K |
| 90677 |
|
598 |
551 |
$63K |
| D1120 |
Prophylaxis - child |
4,126 |
4,091 |
$55K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,670 |
4,509 |
$51K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,260 |
995 |
$46K |
| D0140 |
Limited oral evaluation - problem focused |
3,065 |
2,909 |
$42K |
| D1110 |
Prophylaxis - adult |
2,174 |
2,154 |
$37K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,609 |
1,599 |
$36K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
998 |
840 |
$31K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,975 |
1,926 |
$31K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,890 |
5,577 |
$30K |
| D0274 |
Bitewings - four radiographic images |
3,492 |
3,464 |
$27K |
| 76830 |
Ultrasound, transvaginal |
378 |
345 |
$23K |
| D0330 |
Panoramic radiographic image |
1,415 |
1,401 |
$18K |
| 90649 |
|
254 |
232 |
$17K |
| 90686 |
|
4,727 |
4,350 |
$14K |
| 90651 |
|
380 |
309 |
$13K |
| 88142 |
|
498 |
481 |
$12K |
| 90697 |
|
246 |
228 |
$10K |
| 99215 |
Prolong outpt/office vis |
207 |
199 |
$8K |
| D7140 |
Extraction, erupted tooth or exposed root |
255 |
139 |
$8K |
| 90688 |
|
514 |
508 |
$6K |
| 90734 |
|
278 |
234 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
1,401 |
1,349 |
$5K |
| 90619 |
|
66 |
57 |
$5K |
| 90670 |
|
1,790 |
1,632 |
$4K |
| 81025 |
|
1,496 |
1,402 |
$4K |
| D0210 |
Intraoral - complete series of radiographic images |
140 |
139 |
$4K |
| 0002A |
|
92 |
92 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
532 |
500 |
$3K |
| 11721 |
|
364 |
271 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
648 |
607 |
$3K |
| 90656 |
|
624 |
538 |
$3K |
| 99173 |
|
1,630 |
1,534 |
$3K |
| 0072A |
|
58 |
57 |
$2K |
| 90474 |
|
287 |
267 |
$2K |
| D1351 |
Sealant - per tooth |
269 |
68 |
$2K |
| 0071A |
|
45 |
42 |
$2K |
| 0001A |
|
54 |
54 |
$1K |
| 0011A |
|
55 |
55 |
$1K |
| 90633 |
|
543 |
489 |
$1K |
| D0602 |
|
207 |
199 |
$840.00 |
| 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 |
895 |
829 |
$616.25 |
| 0012A |
|
23 |
23 |
$614.40 |
| 36416 |
|
74 |
67 |
$498.15 |
| D0230 |
Intraoral - periapical each additional radiographic image |
266 |
116 |
$451.00 |
| D0272 |
Bitewings - two radiographic images |
89 |
89 |
$445.00 |
| 83655 |
|
79 |
69 |
$435.95 |
| 90680 |
|
1,095 |
963 |
$350.00 |
| D0603 |
|
51 |
50 |
$320.00 |
| 11720 |
|
231 |
223 |
$300.72 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
14 |
14 |
$195.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
64 |
59 |
$181.13 |
| 99383 |
|
14 |
14 |
$171.39 |
| D0180 |
|
12 |
12 |
$168.00 |
| G0127 |
Trimming of dystrophic nails, any number |
55 |
55 |
$150.96 |
| 90698 |
|
286 |
258 |
$140.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
13 |
13 |
$130.00 |
| 90715 |
|
67 |
58 |
$128.75 |
| 90716 |
|
78 |
66 |
$90.00 |
| 90836 |
|
681 |
538 |
$88.79 |
| 90834 |
Psychotherapy, 45 minutes with patient |
883 |
747 |
$44.63 |
| 90700 |
|
26 |
25 |
$35.48 |
| 90707 |
|
36 |
32 |
$25.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
17 |
17 |
$16.00 |
| 81002 |
|
201 |
126 |
$15.20 |
| 91307 |
|
138 |
130 |
$14.00 |
| 88164 |
|
44 |
27 |
$12.00 |
| 91301 |
|
71 |
71 |
$9.00 |
| 91300 |
|
99 |
97 |
$5.00 |
| 3074F |
|
1,151 |
1,038 |
$0.00 |
| 99381 |
|
1,180 |
1,167 |
$0.00 |
| 3075F |
|
27 |
27 |
$0.00 |
| D1330 |
|
1,591 |
1,564 |
$0.00 |
| 0501F |
|
32 |
29 |
$0.00 |
| 86580 |
|
110 |
100 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 3079F |
|
125 |
123 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
57 |
57 |
$0.00 |
| 90723 |
|
43 |
43 |
$0.00 |
| 90744 |
|
17 |
17 |
$0.00 |
| D0601 |
|
14 |
14 |
$0.00 |
| D1999 |
|
969 |
844 |
$0.00 |
| 3078F |
|
1,103 |
999 |
$0.00 |
| 90648 |
|
98 |
92 |
$0.00 |
| 3077F |
|
25 |
24 |
$0.00 |
| 0502F |
|
33 |
27 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
40 |
39 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
31 |
26 |
$0.00 |
| 90380 |
|
34 |
34 |
$0.00 |