| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
188,279 |
160,015 |
$37.78M |
| 00003 |
Internal/system code - not a standard HCPCS code |
13,166 |
7,330 |
$3.65M |
| 0012A |
|
3,131 |
1,593 |
$143K |
| 0011A |
|
3,008 |
1,547 |
$115K |
| D1120 |
Prophylaxis - child |
5,318 |
3,970 |
$89K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
5,095 |
3,483 |
$85K |
| D1206 |
Topical application of fluoride varnish |
10,746 |
8,540 |
$67K |
| D4341 |
|
3,669 |
1,719 |
$45K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
7,363 |
6,175 |
$45K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
3,348 |
2,267 |
$41K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
104,293 |
72,549 |
$41K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,768 |
1,615 |
$34K |
| D4910 |
|
1,562 |
1,001 |
$34K |
| 90791 |
Psychiatric diagnostic evaluation |
1,258 |
863 |
$34K |
| D9999 |
Unspecified adjunctive procedure, by report |
421 |
399 |
$32K |
| 96156 |
|
3,567 |
2,656 |
$32K |
| D0210 |
Intraoral - complete series of radiographic images |
4,871 |
4,106 |
$31K |
| D0220 |
Intraoral - periapical first radiographic image |
12,487 |
9,379 |
$28K |
| D0120 |
Periodic oral evaluation - established patient |
5,992 |
4,335 |
$27K |
| D1310 |
|
6,250 |
5,162 |
$25K |
| 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 |
705 |
638 |
$23K |
| D0230 |
Intraoral - periapical each additional radiographic image |
11,016 |
5,246 |
$22K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
979 |
729 |
$20K |
| D1110 |
Prophylaxis - adult |
2,724 |
2,356 |
$18K |
| D9430 |
|
6,168 |
4,449 |
$17K |
| D0274 |
Bitewings - four radiographic images |
4,844 |
3,657 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
23,578 |
17,154 |
$15K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
33,032 |
23,993 |
$14K |
| 96127 |
|
7,255 |
6,362 |
$12K |
| 90739 |
|
212 |
163 |
$7K |
| D0603 |
|
4,642 |
4,068 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,517 |
2,591 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,128 |
2,434 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12,673 |
10,085 |
$6K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
515 |
419 |
$5K |
| D1351 |
Sealant - per tooth |
500 |
332 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,621 |
1,950 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,706 |
3,745 |
$5K |
| 90686 |
|
3,839 |
3,022 |
$4K |
| 0064A |
|
107 |
88 |
$4K |
| 99215 |
Prolong outpt/office vis |
1,814 |
1,272 |
$4K |
| D2740 |
Crown - porcelain/ceramic |
22 |
12 |
$3K |
| D0330 |
Panoramic radiographic image |
1,882 |
1,402 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,526 |
1,141 |
$3K |
| D9993 |
|
4,692 |
4,551 |
$3K |
| 90677 |
|
64 |
49 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,664 |
1,308 |
$3K |
| 99383 |
|
793 |
624 |
$2K |
| 90715 |
|
716 |
581 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,146 |
878 |
$2K |
| D0270 |
|
2,895 |
2,158 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
95 |
42 |
$2K |
| 97802 |
|
335 |
285 |
$2K |
| 99442 |
|
2,131 |
1,856 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,132 |
867 |
$2K |
| 97803 |
|
268 |
176 |
$1K |
| D0602 |
|
709 |
547 |
$1K |
| 90480 |
|
171 |
144 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
1,360 |
1,262 |
$1K |
| D7140 |
Extraction, erupted tooth or exposed root |
489 |
419 |
$1K |
| H0049 |
Alcohol and/or drug screening |
479 |
380 |
$1K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
225 |
143 |
$981.97 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
693 |
554 |
$956.25 |
| 99443 |
|
1,221 |
1,047 |
$951.41 |
| 99188 |
|
866 |
686 |
$918.00 |
| 90688 |
|
266 |
199 |
$907.00 |
| 83655 |
|
468 |
350 |
$843.02 |
| 92587 |
|
89 |
78 |
$738.00 |
| D2331 |
|
211 |
184 |
$725.00 |
| 90651 |
|
328 |
260 |
$675.17 |
| 90656 |
|
229 |
201 |
$618.65 |
| 99406 |
|
136 |
133 |
$614.19 |
| 92551 |
|
3,664 |
2,898 |
$582.42 |
| 93000 |
|
630 |
481 |
$579.19 |
| 90670 |
|
1,380 |
1,103 |
$574.26 |
| 99381 |
|
172 |
134 |
$538.30 |
| D0272 |
Bitewings - two radiographic images |
293 |
244 |
$525.00 |
| 99384 |
|
314 |
244 |
$514.10 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
366 |
313 |
$510.70 |
| 90710 |
|
580 |
454 |
$500.90 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
207 |
189 |
$440.88 |
| 99382 |
|
410 |
297 |
$363.36 |
| D0601 |
|
424 |
394 |
$342.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,852 |
2,460 |
$236.78 |
| 99441 |
|
930 |
711 |
$214.45 |
| 90658 |
|
50 |
35 |
$181.60 |
| 90734 |
|
168 |
128 |
$173.20 |
| 92552 |
|
517 |
389 |
$151.47 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
337 |
268 |
$139.67 |
| 90744 |
|
286 |
212 |
$136.58 |
| 0071A |
|
74 |
57 |
$134.00 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,202 |
1,100 |
$129.36 |
| 90633 |
|
1,189 |
917 |
$105.51 |
| 90698 |
|
249 |
181 |
$99.11 |
| 85018 |
|
2,408 |
2,004 |
$96.14 |
| D0350 |
|
738 |
661 |
$89.60 |
| 90694 |
|
71 |
65 |
$76.14 |
| 81025 |
|
376 |
309 |
$70.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
44 |
37 |
$63.89 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
58 |
47 |
$54.90 |
| 81002 |
|
1,130 |
906 |
$53.75 |
| D9110 |
|
37 |
32 |
$45.00 |
| 90700 |
|
207 |
170 |
$40.36 |
| 90723 |
|
913 |
727 |
$36.36 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
235 |
194 |
$33.00 |
| 96160 |
|
2,265 |
1,805 |
$27.68 |
| 90713 |
|
69 |
59 |
$27.02 |
| 90680 |
|
86 |
68 |
$27.01 |
| 90647 |
|
350 |
270 |
$18.25 |
| 83026 |
|
3,388 |
2,797 |
$18.06 |
| 90696 |
|
135 |
109 |
$18.05 |
| 96150 |
|
32 |
27 |
$18.03 |
| 90716 |
|
123 |
104 |
$18.02 |
| 90681 |
|
135 |
114 |
$18.01 |
| 99000 |
|
17 |
12 |
$14.96 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
206 |
152 |
$13.98 |
| 90648 |
|
537 |
432 |
$9.08 |
| 90707 |
|
15 |
14 |
$9.00 |
| 99173 |
|
4,518 |
3,877 |
$0.00 |
| 3077F |
|
3,406 |
2,933 |
$0.00 |
| 3078F |
|
10,377 |
8,925 |
$0.00 |
| D9986 |
|
378 |
363 |
$0.00 |
| 1160F |
|
2,058 |
1,826 |
$0.00 |
| 99177 |
|
821 |
704 |
$0.00 |
| D9990 |
|
741 |
651 |
$0.00 |
| 1159F |
|
2,353 |
2,091 |
$0.00 |
| 3050F |
|
22 |
19 |
$0.00 |
| D2999 |
|
74 |
65 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
57 |
57 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
154 |
111 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
115 |
94 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
444 |
340 |
$0.00 |
| 90461 |
|
259 |
183 |
$0.00 |
| D9996 |
|
251 |
235 |
$0.00 |
| D0191 |
|
24 |
21 |
$0.00 |
| D2950 |
|
27 |
25 |
$0.00 |
| 91322 |
|
54 |
44 |
$0.00 |
| 90653 |
|
14 |
12 |
$0.00 |
| D9987 |
|
14 |
12 |
$0.00 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
12 |
12 |
$0.00 |
| 91313 |
|
22 |
20 |
$0.00 |
| 3074F |
|
10,824 |
9,228 |
$0.00 |
| 3079F |
|
4,524 |
3,855 |
$0.00 |
| D1330 |
|
10,324 |
8,481 |
$0.00 |
| 3008F |
|
14,247 |
12,101 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
317 |
262 |
$0.00 |
| 3080F |
|
1,069 |
936 |
$0.00 |
| 3075F |
|
1,986 |
1,747 |
$0.00 |
| D5899 |
|
368 |
287 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
58 |
55 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
181 |
166 |
$0.00 |
| 82962 |
|
127 |
120 |
$0.00 |
| 3048F |
|
34 |
28 |
$0.00 |
| 4010F |
|
607 |
525 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
39 |
29 |
$0.00 |
| 3044F |
|
164 |
146 |
$0.00 |
| D4342 |
|
102 |
82 |
$0.00 |
| 91306 |
|
16 |
15 |
$0.00 |
| 91307 |
|
108 |
86 |
$0.00 |
| 1170F |
|
190 |
161 |
$0.00 |
| 1101F |
|
13 |
13 |
$0.00 |
| D0171 |
|
36 |
34 |
$0.00 |
| 1036F |
|
26 |
26 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
93 |
88 |
$0.00 |
| D2330 |
|
56 |
49 |
$0.00 |
| 3049F |
|
19 |
15 |
$0.00 |
| 99385 |
|
28 |
23 |
$0.00 |
| 1125F |
|
13 |
12 |
$0.00 |
| 90474 |
|
17 |
14 |
$0.00 |