| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
98,623 |
69,050 |
$11.69M |
| D0999 |
Unspecified diagnostic procedure, by report |
38,628 |
21,919 |
$2.95M |
| H2020 |
Therapeutic behavioral services, per diem |
4,445 |
1,429 |
$440K |
| D7140 |
Extraction, erupted tooth or exposed root |
12,449 |
4,077 |
$50K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12,487 |
7,747 |
$41K |
| D1110 |
Prophylaxis - adult |
9,335 |
5,897 |
$32K |
| D0330 |
Panoramic radiographic image |
6,949 |
4,345 |
$21K |
| D0120 |
Periodic oral evaluation - established patient |
9,088 |
6,063 |
$13K |
| D0272 |
Bitewings - two radiographic images |
7,421 |
4,767 |
$8K |
| D0220 |
Intraoral - periapical first radiographic image |
5,842 |
3,613 |
$6K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,508 |
876 |
$2K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
246 |
85 |
$1K |
| D0160 |
|
296 |
193 |
$1K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
238 |
95 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
44,975 |
32,663 |
$926.36 |
| D0274 |
Bitewings - four radiographic images |
464 |
261 |
$850.00 |
| 0071A |
|
77 |
44 |
$75.00 |
| 90480 |
|
13 |
13 |
$40.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,944 |
3,058 |
$10.00 |
| 81003 |
|
26,343 |
18,068 |
$1.79 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
10,552 |
8,389 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,786 |
2,294 |
$0.00 |
| 81025 |
|
18,176 |
13,907 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,779 |
1,458 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
34 |
28 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,118 |
2,496 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
526 |
468 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,311 |
2,675 |
$0.00 |
| 86703 |
|
288 |
250 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,586 |
3,681 |
$0.00 |
| D1120 |
Prophylaxis - child |
2,411 |
1,964 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,606 |
2,135 |
$0.00 |
| 90633 |
|
929 |
777 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
5,269 |
1,528 |
$0.00 |
| 59425 |
|
572 |
193 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,367 |
1,050 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,656 |
1,338 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
2,461 |
1,922 |
$0.00 |
| 99173 |
|
7,544 |
5,933 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,426 |
2,072 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
339 |
275 |
$0.00 |
| 90671 |
|
139 |
108 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
2,037 |
1,637 |
$0.00 |
| 90672 |
|
471 |
405 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,876 |
1,573 |
$0.00 |
| 90685 |
|
578 |
430 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,118 |
1,714 |
$0.00 |
| 90670 |
|
1,551 |
1,281 |
$0.00 |
| 99354 |
|
97 |
26 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
292 |
215 |
$0.00 |
| 59426 |
|
768 |
225 |
$0.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
15 |
14 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
275 |
245 |
$0.00 |
| 3077F |
|
319 |
255 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
344 |
307 |
$0.00 |
| 99382 |
|
169 |
149 |
$0.00 |
| D9110 |
|
662 |
428 |
$0.00 |
| 90710 |
|
182 |
143 |
$0.00 |
| 3078F |
|
33 |
32 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
68 |
65 |
$0.00 |
| 90700 |
|
63 |
43 |
$0.00 |
| 90473 |
|
423 |
352 |
$0.00 |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
49 |
14 |
$0.00 |
| 90734 |
|
90 |
83 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
27 |
14 |
$0.00 |
| D1999 |
|
32 |
32 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
151 |
115 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
274 |
164 |
$0.00 |
| 80305 |
|
14 |
12 |
$0.00 |
| 90707 |
|
37 |
34 |
$0.00 |
| 90461 |
|
44 |
40 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
16 |
12 |
$0.00 |
| 91308 |
|
25 |
12 |
$0.00 |
| 90474 |
|
955 |
769 |
$0.00 |
| 99000 |
|
4,442 |
3,307 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
570 |
480 |
$0.00 |
| 88142 |
|
1,705 |
1,282 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,442 |
1,799 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
928 |
701 |
$0.00 |
| 92551 |
|
7,501 |
6,091 |
$0.00 |
| 94760 |
|
1,404 |
1,096 |
$0.00 |
| 87340 |
|
190 |
162 |
$0.00 |
| 82962 |
|
1,732 |
1,214 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,115 |
1,710 |
$0.00 |
| 90697 |
|
229 |
174 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,506 |
1,976 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
198 |
153 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
12 |
12 |
$0.00 |
| 99385 |
|
977 |
762 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,182 |
7,357 |
$0.00 |
| 91307 |
|
202 |
103 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
769 |
655 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,522 |
867 |
$0.00 |
| 90680 |
|
817 |
645 |
$0.00 |
| 90651 |
|
432 |
314 |
$0.00 |
| 90647 |
|
463 |
406 |
$0.00 |
| 90686 |
|
2,578 |
2,136 |
$0.00 |
| 90619 |
|
124 |
87 |
$0.00 |
| 1036F |
|
462 |
331 |
$0.00 |
| 59430 |
|
40 |
26 |
$0.00 |
| 86592 |
|
342 |
300 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
513 |
324 |
$0.00 |
| 93000 |
|
110 |
87 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
899 |
698 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
307 |
236 |
$0.00 |
| 87428 |
|
1,186 |
772 |
$0.00 |
| 99384 |
|
165 |
136 |
$0.00 |
| 3080F |
|
213 |
170 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
197 |
162 |
$0.00 |
| 90723 |
|
513 |
427 |
$0.00 |
| 86803 |
|
310 |
279 |
$0.00 |
| 3079F |
|
205 |
167 |
$0.00 |
| 81000 |
|
410 |
350 |
$0.00 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
87 |
68 |
$0.00 |
| 90688 |
|
225 |
206 |
$0.00 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
96 |
79 |
$0.00 |
| 99383 |
|
375 |
329 |
$0.00 |
| 90656 |
|
144 |
104 |
$0.00 |
| 0072A |
|
81 |
47 |
$0.00 |
| 90660 |
|
137 |
100 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
15 |
13 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
19 |
13 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
62 |
45 |
$0.00 |
| 90696 |
|
115 |
96 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
49 |
41 |
$0.00 |
| 3074F |
|
84 |
78 |
$0.00 |
| 3075F |
|
35 |
28 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
17 |
13 |
$0.00 |
| 90677 |
|
68 |
67 |
$0.00 |
| 81001 |
|
32 |
25 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
48 |
30 |
$0.00 |
| 91301 |
|
23 |
15 |
$0.00 |
| 87623 |
|
17 |
17 |
$0.00 |
| 94761 |
|
69 |
51 |
$0.00 |
| 99386 |
|
61 |
43 |
$0.00 |
| 99381 |
|
13 |
13 |
$0.00 |
| 90716 |
|
36 |
33 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
55 |
47 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
56 |
50 |
$0.00 |
| 80050 |
General health panel |
14 |
13 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
15 |
12 |
$0.00 |