| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
37,142 |
29,823 |
$5.47M |
| D9450 |
|
18,228 |
13,746 |
$1.02M |
| 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 |
11,975 |
9,815 |
$397K |
| 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 |
4,151 |
3,567 |
$284K |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,928 |
3,864 |
$202K |
| D1110 |
Prophylaxis - adult |
4,477 |
3,844 |
$186K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,150 |
877 |
$123K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
724 |
724 |
$117K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,599 |
1,177 |
$103K |
| D0140 |
Limited oral evaluation - problem focused |
3,046 |
2,528 |
$96K |
| D0120 |
Periodic oral evaluation - established patient |
4,777 |
4,185 |
$87K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,548 |
1,028 |
$78K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
471 |
468 |
$73K |
| D0210 |
Intraoral - complete series of radiographic images |
1,258 |
1,107 |
$72K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,172 |
12,598 |
$63K |
| D0274 |
Bitewings - four radiographic images |
1,804 |
1,612 |
$55K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
445 |
255 |
$50K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
2,335 |
2,058 |
$44K |
| D0220 |
Intraoral - periapical first radiographic image |
3,380 |
2,797 |
$41K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,749 |
1,445 |
$35K |
| D2331 |
|
405 |
291 |
$31K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
235 |
235 |
$30K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
364 |
307 |
$27K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
133 |
131 |
$23K |
| D1206 |
Topical application of fluoride varnish |
825 |
815 |
$22K |
| D1120 |
Prophylaxis - child |
387 |
383 |
$20K |
| D0330 |
Panoramic radiographic image |
315 |
294 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
90 |
86 |
$16K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
509 |
451 |
$16K |
| 90686 |
|
1,735 |
1,728 |
$16K |
| 90832 |
Psychotherapy, 30 minutes with patient |
664 |
587 |
$15K |
| 90677 |
|
55 |
54 |
$15K |
| D2330 |
|
256 |
144 |
$13K |
| 90791 |
Psychiatric diagnostic evaluation |
149 |
148 |
$13K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,316 |
767 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,103 |
3,057 |
$12K |
| 90715 |
|
479 |
476 |
$12K |
| D2332 |
|
133 |
94 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,034 |
945 |
$11K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,569 |
1,530 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,366 |
9,195 |
$11K |
| D4342 |
|
158 |
68 |
$10K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
203 |
199 |
$8K |
| D0180 |
|
222 |
215 |
$7K |
| 90688 |
|
592 |
591 |
$7K |
| D2335 |
|
47 |
42 |
$7K |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
56 |
50 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
633 |
609 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
139 |
138 |
$5K |
| 90750 |
|
30 |
30 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,508 |
1,206 |
$5K |
| 96127 |
|
493 |
441 |
$4K |
| D0270 |
|
312 |
292 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
299 |
280 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
241 |
212 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
620 |
484 |
$3K |
| 99050 |
|
70 |
70 |
$3K |
| D9110 |
|
92 |
66 |
$2K |
| 99173 |
|
282 |
274 |
$2K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
45 |
23 |
$2K |
| 81002 |
|
775 |
736 |
$2K |
| 97802 |
|
51 |
49 |
$2K |
| 0064A |
|
35 |
35 |
$2K |
| D1354 |
|
240 |
40 |
$1K |
| 90461 |
|
165 |
154 |
$895.44 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
27 |
13 |
$880.20 |
| 99188 |
|
33 |
32 |
$832.00 |
| D0272 |
Bitewings - two radiographic images |
29 |
28 |
$710.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
118 |
115 |
$690.96 |
| 99442 |
|
88 |
83 |
$603.49 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
261 |
245 |
$422.94 |
| 90651 |
|
40 |
40 |
$420.92 |
| 99215 |
Prolong outpt/office vis |
60 |
55 |
$320.34 |
| 82962 |
|
3,011 |
2,814 |
$218.66 |
| 93000 |
|
15 |
12 |
$184.20 |
| 90670 |
|
55 |
55 |
$160.00 |
| 99401 |
|
127 |
117 |
$145.68 |
| 87275 |
|
13 |
13 |
$120.34 |
| 99408 |
|
43 |
38 |
$110.96 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
33 |
33 |
$81.86 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
4,280 |
3,941 |
$40.00 |
| 36416 |
|
397 |
343 |
$2.00 |
| 99000 |
|
902 |
806 |
$0.20 |
| H0049 |
Alcohol and/or drug screening |
485 |
467 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
774 |
741 |
$0.00 |
| 1000F |
|
1,004 |
928 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
292 |
291 |
$0.00 |
| 91301 |
|
439 |
429 |
$0.00 |
| 99406 |
|
191 |
185 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
83 |
82 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
38 |
38 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
53 |
52 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
255 |
239 |
$0.00 |
| 99051 |
|
319 |
302 |
$0.00 |
| 91300 |
|
136 |
119 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
2,956 |
2,732 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
54 |
50 |
$0.00 |
| 90633 |
|
26 |
26 |
$0.00 |
| 90648 |
|
55 |
55 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
50 |
50 |
$0.00 |
| 99001 |
|
399 |
377 |
$0.00 |
| 90734 |
|
25 |
25 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
90 |
86 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
12 |
12 |
$0.00 |
| D2951 |
|
12 |
12 |
$0.00 |