| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
83,826 |
58,194 |
$9.28M |
| D0999 |
Unspecified diagnostic procedure, by report |
27,461 |
17,503 |
$2.43M |
| H2020 |
Therapeutic behavioral services, per diem |
20,467 |
11,220 |
$2.09M |
| D7140 |
Extraction, erupted tooth or exposed root |
5,193 |
1,700 |
$20K |
| D1110 |
Prophylaxis - adult |
7,433 |
4,991 |
$13K |
| 98960 |
|
1,151 |
292 |
$12K |
| D0140 |
Limited oral evaluation - problem focused |
6,598 |
3,946 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,159 |
2,770 |
$6K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
1,201 |
685 |
$5K |
| 0001A |
|
694 |
192 |
$5K |
| 99051 |
|
389 |
334 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
6,566 |
3,909 |
$4K |
| D0330 |
Panoramic radiographic image |
916 |
492 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
7,437 |
5,492 |
$4K |
| 0002A |
|
510 |
137 |
$4K |
| 0031A |
|
406 |
147 |
$2K |
| 0012A |
|
496 |
159 |
$2K |
| 0011A |
|
542 |
170 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
332 |
208 |
$1K |
| D0274 |
Bitewings - four radiographic images |
3,666 |
2,170 |
$1K |
| D2140 |
|
878 |
536 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43,787 |
33,441 |
$911.41 |
| D0230 |
Intraoral - periapical each additional radiographic image |
748 |
309 |
$296.60 |
| D0272 |
Bitewings - two radiographic images |
2,364 |
1,861 |
$251.57 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,748 |
4,777 |
$226.24 |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,038 |
2,060 |
$200.16 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,309 |
1,000 |
$174.59 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
24 |
12 |
$164.28 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
941 |
641 |
$152.20 |
| 90837 |
Psychotherapy, 53 minutes with patient |
4,335 |
1,869 |
$151.55 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,557 |
1,291 |
$141.76 |
| 90834 |
Psychotherapy, 45 minutes with patient |
6,764 |
3,359 |
$114.81 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,308 |
6,584 |
$112.77 |
| 92552 |
|
5,628 |
4,299 |
$99.90 |
| 3044F |
|
117 |
91 |
$80.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
182 |
140 |
$59.70 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,849 |
1,311 |
$39.39 |
| 96127 |
|
2,127 |
1,215 |
$37.74 |
| 90461 |
|
244 |
166 |
$30.33 |
| 87400 |
|
1,440 |
1,176 |
$23.88 |
| 99173 |
|
6,633 |
4,886 |
$17.43 |
| 85018 |
|
5,819 |
4,204 |
$17.12 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,044 |
678 |
$13.13 |
| 81003 |
|
10,037 |
7,417 |
$11.64 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,044 |
682 |
$10.11 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,684 |
2,956 |
$7.73 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
92 |
76 |
$0.12 |
| 99406 |
|
2,981 |
1,967 |
$0.01 |
| D1120 |
Prophylaxis - child |
4,342 |
3,512 |
$0.00 |
| 99188 |
|
827 |
575 |
$0.00 |
| 96160 |
|
1,871 |
1,281 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
555 |
449 |
$0.00 |
| 91300 |
|
1,202 |
364 |
$0.00 |
| 3078F |
|
177 |
130 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
1,927 |
1,463 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
923 |
805 |
$0.00 |
| 92553 |
|
148 |
90 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
37 |
32 |
$0.00 |
| 80305 |
|
121 |
98 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
56 |
53 |
$0.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
65 |
54 |
$0.00 |
| 90756 |
|
61 |
48 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
254 |
194 |
$0.00 |
| D1999 |
|
147 |
123 |
$0.00 |
| 11721 |
|
134 |
114 |
$0.00 |
| 3077F |
|
59 |
41 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
83 |
63 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
100 |
74 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
64 |
29 |
$0.00 |
| D0160 |
|
22 |
12 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
17 |
12 |
$0.00 |
| D0990 |
|
21 |
12 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
74 |
38 |
$0.00 |
| 81025 |
|
30 |
24 |
$0.00 |
| 83655 |
|
34 |
34 |
$0.00 |
| 90686 |
|
588 |
455 |
$0.00 |
| 3008F |
|
12,748 |
8,782 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
5,157 |
4,223 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,532 |
1,053 |
$0.00 |
| 82962 |
|
7,055 |
5,341 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
542 |
464 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
7,193 |
5,613 |
$0.00 |
| 82044 |
|
654 |
547 |
$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 |
816 |
667 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,299 |
895 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,651 |
2,102 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
33 |
29 |
$0.00 |
| 3080F |
|
94 |
66 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
179 |
147 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
121 |
105 |
$0.00 |
| G9226 |
Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) |
173 |
122 |
$0.00 |
| G0433 |
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening |
32 |
15 |
$0.00 |
| 1036F |
|
15 |
12 |
$0.00 |
| 3079F |
|
234 |
169 |
$0.00 |
| 91301 |
|
792 |
339 |
$0.00 |
| 3074F |
|
259 |
191 |
$0.00 |
| 99000 |
|
244 |
175 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
95 |
76 |
$0.00 |
| 90688 |
|
41 |
38 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
26 |
25 |
$0.00 |
| 93000 |
|
45 |
38 |
$0.00 |
| 91303 |
|
287 |
140 |
$0.00 |
| D1351 |
Sealant - per tooth |
257 |
62 |
$0.00 |
| 90656 |
|
88 |
68 |
$0.00 |
| 3075F |
|
60 |
40 |
$0.00 |
| 90674 |
|
33 |
31 |
$0.00 |
| 99384 |
|
95 |
31 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
18 |
18 |
$0.00 |
| 99383 |
|
52 |
33 |
$0.00 |
| 92250 |
|
12 |
12 |
$0.00 |