| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
92,372 |
56,703 |
$15.79M |
| D9999 |
Unspecified adjunctive procedure, by report |
42,960 |
33,151 |
$4.95M |
| D0999 |
Unspecified diagnostic procedure, by report |
13,533 |
11,392 |
$2.68M |
| 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 |
1,542 |
1,125 |
$27K |
| D0120 |
Periodic oral evaluation - established patient |
8,688 |
7,997 |
$15K |
| D1120 |
Prophylaxis - child |
4,931 |
4,606 |
$14K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
4,315 |
2,985 |
$13K |
| D1206 |
Topical application of fluoride varnish |
6,557 |
6,090 |
$10K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
3,293 |
2,213 |
$9K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
898 |
410 |
$8K |
| D1110 |
Prophylaxis - adult |
4,506 |
4,169 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
6,034 |
5,561 |
$7K |
| D0330 |
Panoramic radiographic image |
7,551 |
6,957 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25,205 |
20,025 |
$6K |
| D0210 |
Intraoral - complete series of radiographic images |
3,615 |
3,206 |
$6K |
| D1999 |
|
29 |
25 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
8,537 |
7,901 |
$5K |
| D0274 |
Bitewings - four radiographic images |
6,915 |
6,455 |
$4K |
| 90834 |
Psychotherapy, 45 minutes with patient |
10,584 |
5,854 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,458 |
17,612 |
$3K |
| D0272 |
Bitewings - two radiographic images |
1,395 |
1,312 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
11,350 |
10,374 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
11,147 |
4,150 |
$2K |
| D4341 |
|
1,710 |
671 |
$809.04 |
| 90791 |
Psychiatric diagnostic evaluation |
1,269 |
1,175 |
$763.44 |
| 0011A |
|
55 |
52 |
$720.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
2,566 |
1,593 |
$713.44 |
| 90837 |
Psychotherapy, 53 minutes with patient |
5,934 |
3,138 |
$570.33 |
| 0012A |
|
32 |
30 |
$520.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
2,898 |
2,698 |
$515.16 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
214 |
197 |
$427.89 |
| 80305 |
|
4,457 |
3,749 |
$394.48 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
8,150 |
6,755 |
$301.60 |
| 81025 |
|
720 |
615 |
$269.46 |
| D0603 |
|
93 |
83 |
$265.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
8,346 |
6,921 |
$227.06 |
| 90686 |
|
321 |
278 |
$182.50 |
| 90688 |
|
214 |
203 |
$175.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,895 |
2,171 |
$174.35 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,547 |
1,376 |
$171.62 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,844 |
2,646 |
$159.83 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
167 |
134 |
$146.48 |
| 90649 |
|
74 |
66 |
$145.36 |
| 87428 |
|
530 |
461 |
$128.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
850 |
791 |
$98.18 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,558 |
1,482 |
$97.86 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,484 |
5,583 |
$94.08 |
| 86703 |
|
1,391 |
1,287 |
$81.42 |
| 81003 |
|
4,627 |
4,166 |
$72.45 |
| 90661 |
|
17 |
17 |
$65.48 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
5,262 |
4,664 |
$58.04 |
| D2331 |
|
202 |
132 |
$53.60 |
| 90715 |
|
71 |
71 |
$36.00 |
| 36415 |
Collection of venous blood by venipuncture |
81 |
64 |
$28.53 |
| 93000 |
|
176 |
168 |
$25.65 |
| 99201 |
|
2,549 |
1,980 |
$25.32 |
| D0270 |
|
59 |
59 |
$23.18 |
| D1354 |
|
24 |
12 |
$20.09 |
| 82043 |
|
189 |
178 |
$13.50 |
| 86803 |
|
661 |
614 |
$7.13 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
250 |
175 |
$5.09 |
| 36416 |
|
2,269 |
2,046 |
$3.17 |
| D4910 |
|
438 |
434 |
$2.62 |
| D4342 |
|
399 |
164 |
$1.43 |
| D2330 |
|
141 |
78 |
$0.77 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
64 |
52 |
$0.55 |
| D9110 |
|
29 |
26 |
$0.09 |
| D2332 |
|
15 |
12 |
$0.08 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
825 |
753 |
$0.00 |
| 99384 |
|
45 |
38 |
$0.00 |
| 85018 |
|
16 |
16 |
$0.00 |
| D1351 |
Sealant - per tooth |
498 |
117 |
$0.00 |
| 91301 |
|
112 |
101 |
$0.00 |
| 90651 |
|
30 |
30 |
$0.00 |
| D1330 |
|
53 |
53 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
14 |
12 |
$0.00 |
| 99383 |
|
48 |
45 |
$0.00 |
| 94760 |
|
41 |
32 |
$0.00 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
115 |
104 |
$0.00 |
| 90656 |
|
14 |
14 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
138 |
86 |
$0.00 |
| 90461 |
|
49 |
29 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
15 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,588 |
1,441 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
315 |
278 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
715 |
648 |
$0.00 |
| 80061 |
Lipid panel |
26 |
24 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
190 |
179 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
58 |
57 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
84 |
74 |
$0.00 |
| 90734 |
|
70 |
68 |
$0.00 |
| 99382 |
|
13 |
12 |
$0.00 |
| 96160 |
|
73 |
69 |
$0.00 |
| 83655 |
|
12 |
12 |
$0.00 |