| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
71,150 |
56,915 |
$5.80M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
51,641 |
29,563 |
$1.07M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18,085 |
10,541 |
$574K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,214 |
2,069 |
$55K |
| 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 |
1,888 |
1,657 |
$47K |
| D0120 |
Periodic oral evaluation - established patient |
10,031 |
8,715 |
$40K |
| D1110 |
Prophylaxis - adult |
5,861 |
5,009 |
$39K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,758 |
2,718 |
$31K |
| D1120 |
Prophylaxis - child |
6,723 |
5,831 |
$30K |
| D1208 |
Topical application of fluoride, excluding varnish |
7,983 |
6,924 |
$29K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
511 |
411 |
$28K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,123 |
644 |
$28K |
| D0330 |
Panoramic radiographic image |
3,452 |
2,936 |
$21K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,330 |
933 |
$17K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
740 |
406 |
$14K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,230 |
857 |
$13K |
| 87428 |
|
744 |
369 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
509 |
316 |
$13K |
| D0274 |
Bitewings - four radiographic images |
3,676 |
3,237 |
$12K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
1,240 |
787 |
$12K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,895 |
2,401 |
$11K |
| 90686 |
|
1,669 |
1,051 |
$9K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,032 |
638 |
$8K |
| D1351 |
Sealant - per tooth |
1,947 |
576 |
$7K |
| D0140 |
Limited oral evaluation - problem focused |
2,163 |
1,770 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
263 |
204 |
$6K |
| 81002 |
|
4,870 |
2,557 |
$6K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
67 |
54 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
465 |
333 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
896 |
616 |
$5K |
| D0272 |
Bitewings - two radiographic images |
1,935 |
1,696 |
$5K |
| 81025 |
|
1,242 |
785 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
201 |
152 |
$3K |
| D2331 |
|
99 |
52 |
$3K |
| D2140 |
|
744 |
459 |
$3K |
| D2160 |
|
158 |
88 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
476 |
136 |
$3K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
30 |
25 |
$2K |
| 0011A |
|
47 |
47 |
$2K |
| 0012A |
|
43 |
43 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
47 |
29 |
$2K |
| D2335 |
|
22 |
13 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
1,590 |
1,368 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
22 |
22 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
46 |
24 |
$1K |
| 96127 |
|
538 |
305 |
$980.49 |
| 90832 |
Psychotherapy, 30 minutes with patient |
48 |
19 |
$963.42 |
| 90670 |
|
121 |
100 |
$608.03 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
233 |
164 |
$553.24 |
| 99459 |
|
33 |
31 |
$460.11 |
| 90715 |
|
33 |
25 |
$390.35 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
121 |
96 |
$329.24 |
| 90656 |
|
16 |
16 |
$154.00 |
| D1206 |
Topical application of fluoride varnish |
60 |
45 |
$150.00 |
| 90734 |
|
62 |
37 |
$145.88 |
| 99173 |
|
107 |
68 |
$144.37 |
| 90633 |
|
111 |
85 |
$117.00 |
| D0270 |
|
168 |
154 |
$76.50 |
| D2330 |
|
21 |
14 |
$51.21 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
22,892 |
20,980 |
$0.00 |
| 1160F |
|
13,609 |
7,408 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
8,455 |
4,668 |
$0.00 |
| 4004F |
|
19,073 |
10,901 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
660 |
405 |
$0.00 |
| 1159F |
|
13,604 |
7,405 |
$0.00 |
| 3078F |
|
9,302 |
5,102 |
$0.00 |
| G8506 |
Patient receiving angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy |
3,100 |
1,860 |
$0.00 |
| 3015F |
|
1,159 |
656 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
1,288 |
737 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
61 |
58 |
$0.00 |
| H1000 |
Prenatal care, at-risk assessment |
28 |
26 |
$0.00 |
| 3077F |
|
44 |
24 |
$0.00 |
| 90685 |
|
39 |
26 |
$0.00 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
12 |
$0.00 |
| 3008F |
|
8,573 |
4,586 |
$0.00 |
| 1036F |
|
20,594 |
11,684 |
$0.00 |
| 3074F |
|
11,509 |
6,322 |
$0.00 |
| 1126F |
|
1,996 |
1,139 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
21,034 |
17,120 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
4,263 |
2,290 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
1,582 |
922 |
$0.00 |
| 3048F |
|
1,826 |
1,111 |
$0.00 |
| 1125F |
|
1,100 |
630 |
$0.00 |
| 3079F |
|
2,495 |
1,416 |
$0.00 |
| 4010F |
|
727 |
388 |
$0.00 |
| G9226 |
Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) |
120 |
71 |
$0.00 |
| 3017F |
|
879 |
489 |
$0.00 |
| 3075F |
|
426 |
249 |
$0.00 |
| 59430 |
|
14 |
14 |
$0.00 |
| 3049F |
|
110 |
76 |
$0.00 |
| 3014F |
|
52 |
27 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
50 |
14 |
$0.00 |
| 90651 |
|
40 |
29 |
$0.00 |
| D1310 |
|
24 |
20 |
$0.00 |
| 90619 |
|
25 |
12 |
$0.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$0.00 |