| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
27,653 |
21,583 |
$5.13M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19,150 |
17,446 |
$764K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,498 |
10,748 |
$648K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,105 |
1,315 |
$104K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,535 |
1,700 |
$97K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
1,445 |
756 |
$82K |
| D0120 |
Periodic oral evaluation - established patient |
2,403 |
2,199 |
$65K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,419 |
1,310 |
$50K |
| D1110 |
Prophylaxis - adult |
1,198 |
1,067 |
$48K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
718 |
505 |
$43K |
| D1206 |
Topical application of fluoride varnish |
2,523 |
2,258 |
$41K |
| D0210 |
Intraoral - complete series of radiographic images |
806 |
725 |
$31K |
| D0140 |
Limited oral evaluation - problem focused |
1,205 |
1,058 |
$30K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,220 |
1,164 |
$30K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
573 |
549 |
$29K |
| D7140 |
Extraction, erupted tooth or exposed root |
637 |
229 |
$29K |
| 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 |
1,145 |
945 |
$27K |
| 0002A |
|
778 |
774 |
$21K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,822 |
1,777 |
$16K |
| 90674 |
|
538 |
536 |
$15K |
| D0274 |
Bitewings - four radiographic images |
1,220 |
1,139 |
$14K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,532 |
1,494 |
$12K |
| 0001A |
|
761 |
755 |
$12K |
| 36415 |
Collection of venous blood by venipuncture |
3,770 |
3,652 |
$12K |
| D0220 |
Intraoral - periapical first radiographic image |
1,252 |
1,134 |
$11K |
| 91320 |
|
119 |
118 |
$11K |
| 0124A |
|
259 |
258 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
105 |
105 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
114 |
113 |
$10K |
| 90686 |
|
586 |
576 |
$9K |
| D0604 |
|
1,432 |
1,082 |
$9K |
| D4341 |
|
211 |
93 |
$8K |
| 82962 |
|
3,135 |
2,926 |
$8K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
275 |
259 |
$7K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
144 |
119 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
112 |
110 |
$6K |
| 0004A |
|
152 |
151 |
$6K |
| 0003A |
|
94 |
94 |
$4K |
| 86803 |
|
289 |
285 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
91 |
57 |
$4K |
| 90480 |
|
144 |
143 |
$4K |
| 86703 |
|
268 |
263 |
$3K |
| D1120 |
Prophylaxis - child |
138 |
125 |
$3K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
177 |
149 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
308 |
255 |
$3K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
153 |
112 |
$3K |
| D1351 |
Sealant - per tooth |
129 |
29 |
$2K |
| D0330 |
Panoramic radiographic image |
120 |
119 |
$2K |
| 90756 |
|
114 |
111 |
$2K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
32 |
26 |
$2K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
540 |
194 |
$2K |
| 80061 |
Lipid panel |
155 |
152 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
28 |
26 |
$2K |
| D1999 |
|
89 |
75 |
$1K |
| 0071A |
|
33 |
33 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
14 |
14 |
$1K |
| 0072A |
|
31 |
31 |
$1K |
| D4910 |
|
13 |
13 |
$1K |
| 90661 |
|
28 |
28 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$950.57 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
77 |
43 |
$737.36 |
| D9992 |
|
59 |
26 |
$600.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$466.67 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
115 |
107 |
$340.30 |
| D0230 |
Intraoral - periapical each additional radiographic image |
114 |
58 |
$283.05 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
12 |
12 |
$258.95 |
| D4342 |
|
19 |
12 |
$213.69 |
| 90672 |
|
14 |
14 |
$202.25 |
| 90651 |
|
16 |
16 |
$96.26 |
| 90734 |
|
14 |
14 |
$84.04 |
| 91300 |
|
1,924 |
1,800 |
$72.57 |
| 90715 |
|
12 |
12 |
$72.42 |
| 90473 |
|
14 |
14 |
$41.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13 |
12 |
$14.23 |
| H2015 |
Comprehensive community support services, per 15 minutes |
17 |
12 |
$10.80 |
| 91307 |
|
67 |
65 |
$0.00 |
| 90694 |
|
12 |
12 |
$0.00 |
| D9630 |
|
270 |
210 |
$0.00 |
| D1330 |
|
3,970 |
3,245 |
$0.00 |
| 99406 |
|
139 |
129 |
$0.00 |
| H0001 |
Alcohol and/or drug assessment |
17 |
16 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
109 |
108 |
$0.00 |
| 96153 |
|
927 |
181 |
$0.00 |
| H0046 |
Mental health services, not otherwise specified |
34 |
32 |
$0.00 |
| 90461 |
|
18 |
18 |
$0.00 |
| 91312 |
|
245 |
244 |
$0.00 |