| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
36,863 |
26,821 |
$3.77M |
| D0999 |
Unspecified diagnostic procedure, by report |
14,331 |
11,404 |
$1.83M |
| H2020 |
Therapeutic behavioral services, per diem |
2,517 |
1,958 |
$250K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,668 |
3,805 |
$4K |
| D0330 |
Panoramic radiographic image |
2,942 |
2,288 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,627 |
8,195 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,192 |
15,415 |
$1K |
| D1110 |
Prophylaxis - adult |
2,066 |
1,893 |
$974.63 |
| D7140 |
Extraction, erupted tooth or exposed root |
3,184 |
1,230 |
$745.85 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
517 |
317 |
$630.94 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
87 |
50 |
$592.84 |
| D2140 |
|
163 |
92 |
$381.69 |
| D0272 |
Bitewings - two radiographic images |
3,631 |
3,107 |
$152.13 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
916 |
759 |
$128.31 |
| 80305 |
|
1,578 |
1,060 |
$121.18 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
772 |
484 |
$62.18 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,515 |
2,866 |
$44.69 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,160 |
2,242 |
$17.39 |
| D0220 |
Intraoral - periapical first radiographic image |
397 |
269 |
$12.05 |
| 90837 |
Psychotherapy, 53 minutes with patient |
129 |
107 |
$0.02 |
| D1120 |
Prophylaxis - child |
1,139 |
1,126 |
$0.00 |
| 81002 |
|
766 |
557 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
515 |
437 |
$0.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
906 |
210 |
$0.00 |
| 81025 |
|
167 |
112 |
$0.00 |
| 80061 |
Lipid panel |
187 |
87 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
154 |
117 |
$0.00 |
| 84439 |
|
304 |
130 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
12 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
26 |
$0.00 |
| D0431 |
|
197 |
182 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
17 |
12 |
$0.00 |
| 87400 |
|
73 |
13 |
$0.00 |
| 54150 |
|
59 |
12 |
$0.00 |
| 83655 |
|
76 |
50 |
$0.00 |
| 3725F |
|
13 |
13 |
$0.00 |
| 82962 |
|
1,780 |
1,321 |
$0.00 |
| 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 |
1,623 |
1,481 |
$0.00 |
| 99460 |
|
649 |
155 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
3,058 |
2,161 |
$0.00 |
| 3351F |
|
627 |
556 |
$0.00 |
| D1330 |
|
391 |
334 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
380 |
144 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
1,492 |
1,408 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
340 |
142 |
$0.00 |
| 99462 |
|
429 |
77 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
637 |
367 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
1,799 |
1,757 |
$0.00 |
| 1036F |
|
30 |
24 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
195 |
122 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
353 |
200 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
127 |
45 |
$0.00 |
| 85018 |
|
90 |
64 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
321 |
131 |
$0.00 |
| Q9992 |
Injection, buprenorphine extended-release (sublocade), greater than 100 mg |
20 |
12 |
$0.00 |
| Q9991 |
Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg |
20 |
12 |
$0.00 |
| D2330 |
|
23 |
12 |
$0.00 |
| 3008F |
|
57 |
34 |
$0.00 |
| 1220F |
|
14 |
12 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
67 |
65 |
$0.00 |