| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
130,546 |
98,885 |
$15.65M |
| H2020 |
Therapeutic behavioral services, per diem |
36,193 |
23,276 |
$3.68M |
| D0999 |
Unspecified diagnostic procedure, by report |
26,174 |
17,308 |
$2.11M |
| D0330 |
Panoramic radiographic image |
10,071 |
6,920 |
$39K |
| D7140 |
Extraction, erupted tooth or exposed root |
4,446 |
1,884 |
$19K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
6,917 |
4,798 |
$18K |
| D0140 |
Limited oral evaluation - problem focused |
2,457 |
1,819 |
$6K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
655 |
349 |
$4K |
| D0274 |
Bitewings - four radiographic images |
5,676 |
3,861 |
$3K |
| D1110 |
Prophylaxis - adult |
1,022 |
721 |
$3K |
| 99051 |
|
109 |
97 |
$2K |
| 3044F |
|
3,496 |
3,063 |
$2K |
| 0011A |
|
598 |
423 |
$2K |
| 71015 |
|
95 |
28 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
970 |
672 |
$1K |
| 0012A |
|
581 |
392 |
$1K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
207 |
113 |
$851.55 |
| 0001A |
|
118 |
97 |
$724.96 |
| 3077F |
|
2,848 |
2,484 |
$525.00 |
| 3079F |
|
3,835 |
3,375 |
$485.00 |
| 3080F |
|
1,892 |
1,672 |
$360.00 |
| 98960 |
|
163 |
96 |
$325.32 |
| 3074F |
|
2,884 |
2,499 |
$290.00 |
| D4341 |
|
111 |
76 |
$228.06 |
| 99050 |
|
33 |
23 |
$197.18 |
| 3075F |
|
1,613 |
1,437 |
$195.00 |
| 3078F |
|
1,676 |
1,436 |
$185.00 |
| D0220 |
Intraoral - periapical first radiographic image |
176 |
146 |
$89.05 |
| 0013A |
|
154 |
107 |
$72.08 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
54,351 |
44,279 |
$66.54 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
51 |
25 |
$34.72 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14,412 |
11,481 |
$24.86 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
7,686 |
4,839 |
$0.07 |
| 92551 |
|
6,500 |
4,888 |
$0.05 |
| 90791 |
Psychiatric diagnostic evaluation |
6,923 |
5,239 |
$0.03 |
| 81000 |
|
4,462 |
3,371 |
$0.02 |
| 99173 |
|
5,942 |
4,464 |
$0.02 |
| 36416 |
|
247 |
147 |
$0.01 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29,266 |
24,025 |
$0.01 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
859 |
695 |
$0.01 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
736 |
540 |
$0.01 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,215 |
872 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,009 |
1,702 |
$0.00 |
| 99383 |
|
12 |
12 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
11,176 |
7,212 |
$0.00 |
| 3008F |
|
17,948 |
14,309 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,903 |
1,402 |
$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 |
887 |
797 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,041 |
3,942 |
$0.00 |
| 85018 |
|
3,497 |
2,317 |
$0.00 |
| 93000 |
|
117 |
108 |
$0.00 |
| 90686 |
|
364 |
342 |
$0.00 |
| 90674 |
|
29 |
27 |
$0.00 |
| 96127 |
|
1,502 |
673 |
$0.00 |
| 91301 |
|
1,226 |
890 |
$0.00 |
| 1126F |
|
501 |
414 |
$0.00 |
| 87808 |
|
335 |
198 |
$0.00 |
| 93922 |
|
42 |
40 |
$0.00 |
| 99385 |
|
171 |
138 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
32 |
30 |
$0.00 |
| 1125F |
|
34 |
30 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
916 |
720 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
45 |
34 |
$0.00 |
| 90723 |
|
40 |
38 |
$0.00 |
| 99381 |
|
34 |
25 |
$0.00 |
| 1036F |
|
606 |
467 |
$0.00 |
| 99384 |
|
36 |
34 |
$0.00 |
| 90688 |
|
88 |
65 |
$0.00 |
| 99000 |
|
13 |
13 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
33 |
30 |
$0.00 |
| 90732 |
|
37 |
31 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
125 |
122 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
102 |
73 |
$0.00 |
| D9999 |
Unspecified adjunctive procedure, by report |
29 |
27 |
$0.00 |
| 99386 |
|
12 |
12 |
$0.00 |
| 90656 |
|
28 |
27 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
37 |
31 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
18 |
13 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
40 |
33 |
$0.00 |
| 99406 |
|
13 |
13 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
26 |
12 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
10,724 |
6,753 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
694 |
630 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
5,881 |
5,083 |
$0.00 |
| 81025 |
|
1,255 |
979 |
$0.00 |
| D9110 |
|
320 |
270 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
492 |
392 |
$0.00 |
| 11056 |
|
253 |
236 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
95 |
70 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
5,126 |
3,011 |
$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 |
1,070 |
971 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
743 |
553 |
$0.00 |
| 3725F |
|
3,096 |
2,296 |
$0.00 |
| 90715 |
|
248 |
192 |
$0.00 |
| 82947 |
|
1,344 |
1,151 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
470 |
398 |
$0.00 |
| 1160F |
|
1,013 |
845 |
$0.00 |
| 90756 |
|
164 |
129 |
$0.00 |
| 90658 |
|
777 |
637 |
$0.00 |
| 87905 |
|
516 |
318 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
1,264 |
928 |
$0.00 |
| 87210 |
|
53 |
42 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
4,281 |
3,578 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
847 |
720 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
170 |
113 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
167 |
115 |
$0.00 |
| 96160 |
|
423 |
283 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
110 |
64 |
$0.00 |
| 90633 |
|
112 |
96 |
$0.00 |
| 91300 |
|
99 |
81 |
$0.00 |
| 99401 |
|
51 |
39 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
435 |
367 |
$0.00 |
| 2028F |
|
145 |
130 |
$0.00 |
| D1120 |
Prophylaxis - child |
200 |
190 |
$0.00 |
| 86328 |
|
144 |
128 |
$0.00 |
| 80061 |
Lipid panel |
18 |
14 |
$0.00 |
| 99201 |
|
251 |
234 |
$0.00 |
| 90648 |
|
75 |
66 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 90670 |
|
120 |
113 |
$0.00 |
| 81002 |
|
46 |
34 |
$0.00 |
| 3046F |
|
12 |
12 |
$0.00 |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
24 |
20 |
$0.00 |
| 0002A |
|
27 |
24 |
$0.00 |