| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
33,647 |
24,459 |
$1.55M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,430 |
13,070 |
$441K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,863 |
5,096 |
$250K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,217 |
4,514 |
$137K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
5,881 |
4,426 |
$85K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,359 |
1,451 |
$79K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,030 |
1,292 |
$69K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,550 |
979 |
$59K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,506 |
1,012 |
$48K |
| D1110 |
Prophylaxis - adult |
2,495 |
2,021 |
$44K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,409 |
1,982 |
$41K |
| D1120 |
Prophylaxis - child |
2,458 |
2,015 |
$25K |
| D0274 |
Bitewings - four radiographic images |
1,103 |
959 |
$23K |
| D0120 |
Periodic oral evaluation - established patient |
2,621 |
1,987 |
$23K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,720 |
2,320 |
$22K |
| D0140 |
Limited oral evaluation - problem focused |
1,805 |
1,253 |
$16K |
| 90837 |
Psychotherapy, 53 minutes with patient |
421 |
151 |
$14K |
| D0272 |
Bitewings - two radiographic images |
2,410 |
1,886 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
454 |
193 |
$11K |
| 92551 |
|
3,167 |
1,964 |
$10K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
218 |
184 |
$8K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
74 |
48 |
$7K |
| 96127 |
|
2,965 |
1,194 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
561 |
430 |
$6K |
| 81025 |
|
1,343 |
1,001 |
$6K |
| 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 |
376 |
346 |
$5K |
| 99215 |
Prolong outpt/office vis |
93 |
65 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
131 |
70 |
$4K |
| 99173 |
|
3,197 |
1,985 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
1,235 |
972 |
$4K |
| 82962 |
|
3,048 |
2,031 |
$3K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
75 |
28 |
$3K |
| D2140 |
|
104 |
52 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
487 |
279 |
$3K |
| 0012A |
|
97 |
97 |
$2K |
| D0330 |
Panoramic radiographic image |
99 |
70 |
$2K |
| 0011A |
|
123 |
121 |
$2K |
| 0013A |
|
72 |
52 |
$2K |
| D1206 |
Topical application of fluoride varnish |
85 |
79 |
$1K |
| 90686 |
|
1,255 |
873 |
$1K |
| 99385 |
|
28 |
15 |
$887.84 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
114 |
70 |
$853.68 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
367 |
222 |
$832.47 |
| 99381 |
|
22 |
12 |
$794.31 |
| 81002 |
|
415 |
271 |
$544.09 |
| 90651 |
|
595 |
403 |
$525.36 |
| 96161 |
|
521 |
375 |
$393.85 |
| 90672 |
|
145 |
93 |
$361.81 |
| 90682 |
|
12 |
12 |
$357.68 |
| 11721 |
|
20 |
13 |
$262.62 |
| 90670 |
|
937 |
742 |
$259.15 |
| D0230 |
Intraoral - periapical each additional radiographic image |
24 |
12 |
$206.43 |
| 0001A |
|
12 |
12 |
$195.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
22 |
12 |
$153.54 |
| 3008F |
|
14,300 |
8,636 |
$57.43 |
| 90744 |
|
503 |
370 |
$41.75 |
| 90715 |
|
96 |
68 |
$37.60 |
| 81003 |
|
44 |
27 |
$27.74 |
| 91301 |
|
386 |
350 |
$2.75 |
| 90633 |
|
357 |
254 |
$1.03 |
| 90698 |
|
818 |
667 |
$0.99 |
| 90710 |
|
255 |
183 |
$0.17 |
| 90700 |
|
19 |
15 |
$0.12 |
| 90734 |
|
229 |
165 |
$0.04 |
| 90621 |
|
78 |
52 |
$0.03 |
| 90696 |
|
20 |
14 |
$0.01 |
| 90716 |
|
25 |
19 |
$0.01 |
| 90681 |
|
32 |
27 |
$0.01 |
| 90707 |
|
25 |
19 |
$0.01 |
| 3075F |
|
648 |
430 |
$0.00 |
| 3074F |
|
9,168 |
5,556 |
$0.00 |
| 1036F |
|
6,523 |
3,926 |
$0.00 |
| 90619 |
|
218 |
135 |
$0.00 |
| 2001F |
|
5,636 |
3,699 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
3,318 |
2,297 |
$0.00 |
| 3079F |
|
2,103 |
1,300 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
3,023 |
2,624 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
239 |
171 |
$0.00 |
| 3080F |
|
368 |
240 |
$0.00 |
| 90674 |
|
58 |
30 |
$0.00 |
| 3044F |
|
15 |
15 |
$0.00 |
| 90620 |
|
24 |
13 |
$0.00 |
| 90677 |
|
30 |
29 |
$0.00 |
| 3078F |
|
8,313 |
5,084 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
3,097 |
2,144 |
$0.00 |
| 3077F |
|
1,191 |
764 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
371 |
274 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
163 |
148 |
$0.00 |
| 90661 |
|
36 |
35 |
$0.00 |
| D9110 |
|
19 |
19 |
$0.00 |
| 90685 |
|
27 |
17 |
$0.00 |