| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
43,494 |
35,064 |
$5.50M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17,667 |
15,342 |
$2.43M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,634 |
4,928 |
$746K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,132 |
1,942 |
$321K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,065 |
1,950 |
$300K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,220 |
1,189 |
$201K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,521 |
770 |
$100K |
| 90832 |
Psychotherapy, 30 minutes with patient |
844 |
548 |
$73K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
372 |
363 |
$69K |
| 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 |
1,375 |
1,000 |
$54K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
274 |
269 |
$46K |
| D1999 |
|
4,590 |
3,863 |
$42K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
220 |
219 |
$39K |
| 90791 |
Psychiatric diagnostic evaluation |
371 |
354 |
$36K |
| D1206 |
Topical application of fluoride varnish |
4,041 |
3,559 |
$19K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
86 |
83 |
$19K |
| 87428 |
|
679 |
632 |
$18K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,949 |
631 |
$17K |
| 90670 |
|
1,046 |
993 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,379 |
2,319 |
$12K |
| 90686 |
|
1,023 |
994 |
$12K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
994 |
607 |
$11K |
| 99215 |
Prolong outpt/office vis |
54 |
51 |
$10K |
| D0120 |
Periodic oral evaluation - established patient |
1,987 |
1,903 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
475 |
441 |
$7K |
| D1120 |
Prophylaxis - child |
1,200 |
1,143 |
$6K |
| 99381 |
|
28 |
28 |
$6K |
| D1110 |
Prophylaxis - adult |
1,266 |
1,220 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
812 |
692 |
$5K |
| 92552 |
|
79 |
79 |
$5K |
| D0274 |
Bitewings - four radiographic images |
1,495 |
1,452 |
$4K |
| D0210 |
Intraoral - complete series of radiographic images |
752 |
720 |
$4K |
| 90647 |
|
415 |
404 |
$4K |
| 85018 |
|
1,370 |
1,317 |
$4K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
14 |
12 |
$3K |
| 90677 |
|
236 |
228 |
$3K |
| 90697 |
|
207 |
199 |
$2K |
| 90681 |
|
186 |
180 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
94 |
88 |
$2K |
| 3008F |
|
1,288 |
1,091 |
$1K |
| 90723 |
|
102 |
100 |
$1K |
| 90633 |
|
93 |
89 |
$933.45 |
| D0272 |
Bitewings - two radiographic images |
593 |
550 |
$786.02 |
| 90710 |
|
62 |
56 |
$556.92 |
| 90700 |
|
52 |
51 |
$543.48 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
71 |
70 |
$522.54 |
| 90656 |
|
31 |
31 |
$446.37 |
| 90651 |
|
30 |
28 |
$327.60 |
| D0140 |
Limited oral evaluation - problem focused |
158 |
157 |
$286.00 |
| 99172 |
|
15 |
15 |
$255.03 |
| D0220 |
Intraoral - periapical first radiographic image |
178 |
178 |
$167.73 |
| D0330 |
Panoramic radiographic image |
200 |
177 |
$144.00 |
| 90688 |
|
12 |
12 |
$131.04 |
| Q3014 |
Telehealth originating site facility fee |
13 |
12 |
$129.90 |
| 90715 |
|
12 |
12 |
$120.12 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
456 |
260 |
$70.94 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
14 |
13 |
$60.20 |
| 99177 |
|
30 |
30 |
$12.25 |
| 3074F |
|
57 |
51 |
$0.19 |
| 3078F |
|
47 |
41 |
$0.17 |
| 3079F |
|
13 |
13 |
$0.05 |
| D1354 |
|
23 |
12 |
$0.00 |
| D0603 |
|
28 |
28 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
692 |
439 |
$0.00 |
| D1351 |
Sealant - per tooth |
330 |
89 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
46 |
40 |
$0.00 |