| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
58,326 |
46,417 |
$12.85M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
23,062 |
19,165 |
$974K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24,349 |
20,396 |
$935K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,897 |
1,589 |
$248K |
| 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 |
4,939 |
3,696 |
$215K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,889 |
1,774 |
$150K |
| D0210 |
Intraoral - complete series of radiographic images |
792 |
779 |
$43K |
| D1110 |
Prophylaxis - adult |
883 |
875 |
$43K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
967 |
926 |
$38K |
| D7140 |
Extraction, erupted tooth or exposed root |
887 |
432 |
$36K |
| 99215 |
Prolong outpt/office vis |
735 |
626 |
$32K |
| D0140 |
Limited oral evaluation - problem focused |
1,083 |
977 |
$29K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
242 |
103 |
$28K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
990 |
833 |
$27K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
403 |
265 |
$25K |
| D0120 |
Periodic oral evaluation - established patient |
560 |
549 |
$21K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
220 |
214 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
194 |
187 |
$16K |
| D1208 |
Topical application of fluoride, excluding varnish |
449 |
449 |
$11K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
125 |
96 |
$11K |
| 98927 |
|
319 |
279 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
103 |
102 |
$9K |
| D1206 |
Topical application of fluoride varnish |
466 |
451 |
$9K |
| D0220 |
Intraoral - periapical first radiographic image |
929 |
813 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
566 |
422 |
$7K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
166 |
110 |
$7K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
135 |
128 |
$6K |
| 90791 |
Psychiatric diagnostic evaluation |
55 |
55 |
$6K |
| 90686 |
|
365 |
358 |
$5K |
| 90832 |
Psychotherapy, 30 minutes with patient |
134 |
94 |
$5K |
| 98926 |
|
158 |
141 |
$4K |
| D2330 |
|
61 |
36 |
$3K |
| 99490 |
Ccm add 20min |
43 |
41 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
141 |
73 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
25 |
$2K |
| 0003A |
|
52 |
50 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
92 |
88 |
$2K |
| 99429 |
|
145 |
139 |
$2K |
| 99499 |
|
121 |
114 |
$2K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
12 |
12 |
$1K |
| D4341 |
|
21 |
15 |
$967.20 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
93 |
90 |
$930.69 |
| D0274 |
Bitewings - four radiographic images |
78 |
62 |
$867.87 |
| 0002A |
|
18 |
18 |
$659.20 |
| 90688 |
|
104 |
61 |
$511.20 |
| 0001A |
|
12 |
12 |
$492.00 |
| 92015 |
Determination of refractive state |
47 |
45 |
$421.10 |
| 99188 |
|
81 |
79 |
$279.40 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
28 |
24 |
$198.18 |
| 80305 |
|
28 |
28 |
$175.27 |
| D0230 |
Intraoral - periapical each additional radiographic image |
73 |
25 |
$78.27 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
78 |
74 |
$55.00 |
| 96127 |
|
12 |
12 |
$53.65 |
| D9999 |
Unspecified adjunctive procedure, by report |
14 |
14 |
$0.00 |
| 90480 |
|
14 |
13 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
16 |
16 |
$0.00 |
| 91300 |
|
116 |
114 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
221 |
200 |
$0.00 |
| 91322 |
|
13 |
12 |
$0.00 |