| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
186,615 |
152,409 |
$49.08M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
34,502 |
30,969 |
$708K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,375 |
15,404 |
$579K |
| 90832 |
Psychotherapy, 30 minutes with patient |
11,004 |
8,945 |
$409K |
| 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 |
4,234 |
3,453 |
$103K |
| 99442 |
|
5,771 |
4,966 |
$87K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,844 |
1,702 |
$83K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,317 |
1,280 |
$63K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,386 |
5,192 |
$56K |
| 90686 |
|
6,979 |
6,816 |
$48K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
879 |
870 |
$43K |
| D1110 |
Prophylaxis - adult |
18,608 |
18,239 |
$42K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
8,608 |
5,628 |
$40K |
| D1206 |
Topical application of fluoride varnish |
36,772 |
35,751 |
$38K |
| D1120 |
Prophylaxis - child |
15,366 |
15,108 |
$34K |
| D7140 |
Extraction, erupted tooth or exposed root |
13,613 |
6,768 |
$31K |
| D0120 |
Periodic oral evaluation - established patient |
23,643 |
23,108 |
$27K |
| 0012A |
|
784 |
765 |
$27K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
2,066 |
1,490 |
$27K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
18,640 |
18,094 |
$23K |
| D1351 |
Sealant - per tooth |
11,610 |
3,825 |
$21K |
| 0011A |
|
768 |
754 |
$21K |
| D0140 |
Limited oral evaluation - problem focused |
24,601 |
23,597 |
$20K |
| 99441 |
|
2,170 |
1,966 |
$18K |
| 91322 |
|
149 |
136 |
$18K |
| D0210 |
Intraoral - complete series of radiographic images |
7,552 |
7,261 |
$17K |
| D0274 |
Bitewings - four radiographic images |
13,769 |
13,439 |
$15K |
| 0064A |
|
514 |
434 |
$15K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
127 |
106 |
$14K |
| 90674 |
|
1,049 |
975 |
$14K |
| 0001A |
|
370 |
361 |
$13K |
| 0002A |
|
344 |
338 |
$12K |
| D4355 |
|
1,496 |
1,469 |
$11K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
3,250 |
2,277 |
$11K |
| 90480 |
|
361 |
315 |
$10K |
| 99443 |
|
492 |
424 |
$10K |
| D0220 |
Intraoral - periapical first radiographic image |
22,071 |
21,143 |
$9K |
| 0071A |
|
318 |
236 |
$9K |
| 0054A |
|
262 |
215 |
$8K |
| 99188 |
|
686 |
653 |
$7K |
| D0272 |
Bitewings - two radiographic images |
5,806 |
5,659 |
$7K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
853 |
593 |
$6K |
| 90677 |
|
143 |
133 |
$6K |
| 0072A |
|
190 |
157 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
111 |
111 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
12,350 |
9,972 |
$4K |
| 0004A |
|
105 |
95 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
39 |
29 |
$3K |
| 90670 |
|
661 |
637 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
297 |
236 |
$2K |
| D2140 |
|
459 |
312 |
$2K |
| 0052A |
|
56 |
46 |
$2K |
| 90656 |
|
91 |
90 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
52 |
52 |
$2K |
| 90723 |
|
343 |
325 |
$2K |
| D0330 |
Panoramic radiographic image |
623 |
610 |
$2K |
| 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 |
31 |
24 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
4,869 |
4,239 |
$1K |
| 0124A |
|
38 |
35 |
$1K |
| 90647 |
|
262 |
251 |
$1K |
| D0191 |
|
4,649 |
4,458 |
$1K |
| 90661 |
|
38 |
38 |
$986.58 |
| 99215 |
Prolong outpt/office vis |
15 |
15 |
$871.48 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
177 |
150 |
$811.92 |
| 90688 |
|
60 |
60 |
$591.24 |
| 0134A |
|
16 |
16 |
$534.24 |
| 0081A |
|
16 |
14 |
$401.84 |
| 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) |
418 |
360 |
$186.07 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
32 |
28 |
$161.97 |
| 90633 |
|
43 |
40 |
$122.47 |
| 76801 |
|
12 |
12 |
$116.13 |
| 90651 |
|
27 |
26 |
$82.75 |
| 90734 |
|
15 |
14 |
$36.41 |
| 90681 |
|
12 |
12 |
$36.41 |
| 87210 |
|
13 |
13 |
$35.05 |
| 3044F |
|
86 |
67 |
$10.00 |
| D0270 |
|
1,302 |
1,275 |
$7.08 |
| 91301 |
|
126 |
125 |
$0.41 |
| 91306 |
|
497 |
432 |
$0.01 |
| D0180 |
|
2,271 |
2,228 |
$0.00 |
| D1354 |
|
578 |
207 |
$0.00 |
| 3078F |
|
385 |
367 |
$0.00 |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
111 |
24 |
$0.00 |
| D0190 |
|
5,193 |
5,160 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
308 |
248 |
$0.00 |
| D2791 |
|
13 |
12 |
$0.00 |
| 91300 |
|
12 |
12 |
$0.00 |
| D2940 |
|
17 |
15 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
35 |
16 |
$0.00 |
| D9996 |
|
59 |
58 |
$0.00 |
| 3074F |
|
671 |
631 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
617 |
607 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
141 |
134 |
$0.00 |
| D5899 |
|
2,288 |
1,131 |
$0.00 |
| D2331 |
|
33 |
25 |
$0.00 |
| D7230 |
|
157 |
103 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
328 |
327 |
$0.00 |
| 91305 |
|
52 |
39 |
$0.00 |
| D7240 |
Removal of impacted tooth - completely bony |
106 |
60 |
$0.00 |
| D2330 |
|
15 |
12 |
$0.00 |
| D0240 |
|
41 |
24 |
$0.00 |