| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
65,495 |
44,812 |
$15.70M |
| D9999 |
Unspecified adjunctive procedure, by report |
23,901 |
18,325 |
$3.57M |
| D0999 |
Unspecified diagnostic procedure, by report |
6,872 |
5,731 |
$1.78M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29,190 |
23,339 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18,217 |
15,601 |
$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 |
1,105 |
893 |
$15K |
| D0140 |
Limited oral evaluation - problem focused |
5,750 |
5,436 |
$7K |
| 3079F |
|
2,703 |
2,448 |
$5K |
| 3077F |
|
1,837 |
1,627 |
$5K |
| 3074F |
|
3,984 |
3,442 |
$4K |
| 3078F |
|
3,055 |
2,648 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
8,547 |
7,824 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
2,839 |
2,683 |
$3K |
| 3075F |
|
1,390 |
1,287 |
$3K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
320 |
311 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
10,189 |
3,266 |
$3K |
| D1110 |
Prophylaxis - adult |
1,166 |
1,100 |
$2K |
| D0274 |
Bitewings - four radiographic images |
2,432 |
2,254 |
$2K |
| 99215 |
Prolong outpt/office vis |
1,089 |
1,009 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
616 |
385 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,374 |
1,218 |
$2K |
| 3044F |
|
289 |
279 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,297 |
1,653 |
$2K |
| D4341 |
|
790 |
314 |
$1K |
| D0270 |
|
2,467 |
2,411 |
$1K |
| D0330 |
Panoramic radiographic image |
199 |
199 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
548 |
508 |
$961.37 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
989 |
942 |
$941.44 |
| D1206 |
Topical application of fluoride varnish |
1,702 |
1,504 |
$887.98 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
201 |
160 |
$819.53 |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,277 |
1,675 |
$692.66 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,714 |
2,374 |
$504.56 |
| 3051F |
|
67 |
65 |
$480.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,004 |
2,123 |
$467.16 |
| 90791 |
Psychiatric diagnostic evaluation |
421 |
395 |
$415.35 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
192 |
141 |
$400.14 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,697 |
3,582 |
$394.65 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,711 |
1,549 |
$371.56 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,447 |
4,222 |
$343.41 |
| D4910 |
|
650 |
613 |
$274.90 |
| 99205 |
Prolong outpt/office vis |
75 |
73 |
$226.62 |
| 99443 |
|
201 |
185 |
$183.50 |
| 90686 |
|
2,065 |
2,001 |
$149.34 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
886 |
814 |
$141.71 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
881 |
833 |
$137.33 |
| 90656 |
|
102 |
102 |
$98.31 |
| 90715 |
|
338 |
323 |
$97.45 |
| 82043 |
|
762 |
737 |
$92.67 |
| 99442 |
|
1,479 |
1,315 |
$71.40 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
163 |
154 |
$70.23 |
| 93000 |
|
92 |
87 |
$51.30 |
| 0011A |
|
42 |
42 |
$40.00 |
| 90480 |
|
124 |
123 |
$25.45 |
| 80305 |
|
153 |
144 |
$22.16 |
| 36415 |
Collection of venous blood by venipuncture |
552 |
519 |
$21.75 |
| 81002 |
|
1,584 |
1,459 |
$17.08 |
| 81003 |
|
264 |
252 |
$6.78 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
55 |
50 |
$2.81 |
| 2001F |
|
4,757 |
3,961 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
27 |
27 |
$0.00 |
| 2000F |
|
4,756 |
3,943 |
$0.00 |
| 0001A |
|
42 |
42 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
224 |
211 |
$0.00 |
| 3008F |
|
10,052 |
8,378 |
$0.00 |
| 3352F |
|
227 |
225 |
$0.00 |
| 1126F |
|
992 |
918 |
$0.00 |
| 1036F |
|
2,306 |
1,897 |
$0.00 |
| 3080F |
|
1,442 |
1,280 |
$0.00 |
| 90732 |
|
46 |
46 |
$0.00 |
| 2010F |
|
4,922 |
4,080 |
$0.00 |
| 1125F |
|
775 |
698 |
$0.00 |
| 85018 |
|
44 |
38 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
316 |
284 |
$0.00 |
| 4010F |
|
1,440 |
1,002 |
$0.00 |
| 3353F |
|
250 |
238 |
$0.00 |
| 1034F |
|
1,889 |
1,511 |
$0.00 |
| D1330 |
|
14 |
14 |
$0.00 |
| 99441 |
|
395 |
367 |
$0.00 |
| 3351F |
|
963 |
918 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
13 |
13 |
$0.00 |
| 99385 |
|
13 |
12 |
$0.00 |
| 4037F |
|
245 |
227 |
$0.00 |
| 90677 |
|
40 |
40 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
31 |
30 |
$0.00 |
| 90651 |
|
17 |
17 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
12 |
12 |
$0.00 |
| 3060F |
|
12 |
12 |
$0.00 |
| 98967 |
|
17 |
16 |
$0.00 |
| 1160F |
|
3,635 |
3,046 |
$0.00 |
| 86703 |
|
406 |
392 |
$0.00 |
| 3046F |
|
37 |
37 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
220 |
202 |
$0.00 |
| 90750 |
|
331 |
325 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
95 |
92 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
221 |
211 |
$0.00 |
| 1159F |
|
3,634 |
3,045 |
$0.00 |
| 80306 |
|
42 |
41 |
$0.00 |
| 81025 |
|
184 |
168 |
$0.00 |
| D1120 |
Prophylaxis - child |
396 |
334 |
$0.00 |
| 90746 |
|
25 |
24 |
$0.00 |
| 4040F |
|
588 |
420 |
$0.00 |
| 4274F |
|
1,927 |
1,226 |
$0.00 |
| 84702 |
|
16 |
16 |
$0.00 |
| 2028F |
|
37 |
36 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
104 |
98 |
$0.00 |
| 98968 |
|
586 |
419 |
$0.00 |
| 85610 |
|
14 |
12 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
28 |
27 |
$0.00 |
| 91322 |
|
26 |
25 |
$0.00 |
| 96160 |
|
36 |
35 |
$0.00 |
| 71046 |
Radiologic examination, chest; 2 views |
56 |
52 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
76 |
63 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |