| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
82,443 |
63,260 |
$9.42M |
| H2020 |
Therapeutic behavioral services, per diem |
32,811 |
13,269 |
$2.29M |
| D0999 |
Unspecified diagnostic procedure, by report |
12,296 |
7,529 |
$949K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
5,638 |
3,250 |
$12K |
| D0210 |
Intraoral - complete series of radiographic images |
3,881 |
2,236 |
$10K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,740 |
676 |
$7K |
| D0330 |
Panoramic radiographic image |
1,566 |
824 |
$5K |
| D1110 |
Prophylaxis - adult |
2,402 |
1,362 |
$5K |
| 3074F |
|
25,377 |
20,030 |
$3K |
| D0140 |
Limited oral evaluation - problem focused |
2,844 |
1,639 |
$2K |
| 3078F |
|
21,432 |
17,136 |
$2K |
| 3079F |
|
12,129 |
9,604 |
$2K |
| D0274 |
Bitewings - four radiographic images |
1,048 |
523 |
$1K |
| 3077F |
|
9,880 |
8,169 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
2,384 |
1,387 |
$1K |
| 3080F |
|
7,222 |
5,874 |
$950.00 |
| D0120 |
Periodic oral evaluation - established patient |
830 |
494 |
$904.98 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26,040 |
18,738 |
$829.24 |
| 3075F |
|
5,385 |
4,385 |
$695.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28,315 |
22,449 |
$486.21 |
| 90834 |
Psychotherapy, 45 minutes with patient |
9,083 |
3,315 |
$404.36 |
| 90791 |
Psychiatric diagnostic evaluation |
1,343 |
664 |
$373.19 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,750 |
1,318 |
$275.31 |
| 0064A |
|
322 |
130 |
$148.02 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,016 |
406 |
$86.64 |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,731 |
1,045 |
$85.94 |
| 0012A |
|
914 |
332 |
$75.42 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
61 |
25 |
$67.35 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,202 |
909 |
$65.13 |
| D0230 |
Intraoral - periapical each additional radiographic image |
212 |
67 |
$55.38 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
20 |
12 |
$53.13 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,003 |
5,622 |
$44.10 |
| 11721 |
|
788 |
576 |
$27.17 |
| 3044F |
|
1,051 |
962 |
$20.00 |
| 0011A |
|
1,143 |
380 |
$13.23 |
| 90686 |
|
2,738 |
2,365 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,388 |
1,144 |
$0.00 |
| 1126F |
|
33,439 |
26,109 |
$0.00 |
| 3008F |
|
38,916 |
30,253 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
4,538 |
3,494 |
$0.00 |
| 96127 |
|
4,733 |
3,615 |
$0.00 |
| 1125F |
|
6,383 |
5,272 |
$0.00 |
| 90474 |
|
228 |
122 |
$0.00 |
| 4037F |
|
1,141 |
994 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,160 |
776 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
42 |
38 |
$0.00 |
| 3048F |
|
1,128 |
1,050 |
$0.00 |
| 3049F |
|
481 |
448 |
$0.00 |
| 90656 |
|
488 |
402 |
$0.00 |
| 90632 |
|
84 |
69 |
$0.00 |
| 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 |
368 |
321 |
$0.00 |
| 90732 |
|
90 |
81 |
$0.00 |
| 91306 |
|
43 |
13 |
$0.00 |
| 91301 |
|
1,250 |
595 |
$0.00 |
| 96146 |
|
828 |
687 |
$0.00 |
| 99381 |
|
90 |
80 |
$0.00 |
| 99406 |
|
24 |
19 |
$0.00 |
| 85018 |
|
232 |
136 |
$0.00 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
62 |
32 |
$0.00 |
| 90696 |
|
127 |
102 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
116 |
92 |
$0.00 |
| 99384 |
|
30 |
16 |
$0.00 |
| 11055 |
|
69 |
33 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
210 |
90 |
$0.00 |
| D1320 |
|
30 |
12 |
$0.00 |
| 92551 |
|
111 |
65 |
$0.00 |
| 90647 |
|
63 |
53 |
$0.00 |
| 99443 |
|
45 |
43 |
$0.00 |
| 99000 |
|
45 |
39 |
$0.00 |
| 99385 |
|
66 |
44 |
$0.00 |
| 99441 |
|
84 |
66 |
$0.00 |
| D1330 |
|
78 |
29 |
$0.00 |
| 99383 |
|
21 |
12 |
$0.00 |
| 91307 |
|
64 |
26 |
$0.00 |
| 97802 |
|
174 |
110 |
$0.00 |
| 90739 |
|
15 |
13 |
$0.00 |
| 1159F |
|
28,879 |
24,670 |
$0.00 |
| 1160F |
|
27,954 |
23,874 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,727 |
6,240 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
4,978 |
3,820 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,254 |
2,524 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
958 |
761 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,823 |
808 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
104 |
80 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
523 |
417 |
$0.00 |
| 2028F |
|
79 |
41 |
$0.00 |
| 81002 |
|
702 |
557 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,713 |
1,324 |
$0.00 |
| 11056 |
|
636 |
475 |
$0.00 |
| 90461 |
|
1,835 |
1,377 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
161 |
135 |
$0.00 |
| 90633 |
|
63 |
58 |
$0.00 |
| 96160 |
|
1,491 |
1,362 |
$0.00 |
| 90746 |
|
18 |
17 |
$0.00 |
| 1158F |
|
206 |
174 |
$0.00 |
| 96103 |
|
382 |
313 |
$0.00 |
| 82947 |
|
299 |
219 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
296 |
230 |
$0.00 |
| 99382 |
|
351 |
278 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
251 |
230 |
$0.00 |
| 91300 |
|
203 |
60 |
$0.00 |
| 81025 |
|
310 |
262 |
$0.00 |
| 3050F |
|
80 |
78 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
319 |
252 |
$0.00 |
| 90670 |
|
133 |
119 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
295 |
233 |
$0.00 |
| 99201 |
|
275 |
202 |
$0.00 |
| D0270 |
|
66 |
39 |
$0.00 |
| 90715 |
|
193 |
138 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
34 |
26 |
$0.00 |
| 99173 |
|
15 |
14 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
55 |
40 |
$0.00 |
| 0071A |
|
41 |
12 |
$0.00 |