| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
55,765 |
45,187 |
$4.47M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
23,539 |
14,153 |
$739K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,770 |
13,073 |
$486K |
| D0330 |
Panoramic radiographic image |
5,245 |
3,791 |
$65K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,188 |
1,918 |
$58K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
5,757 |
4,076 |
$42K |
| 90837 |
Psychotherapy, 53 minutes with patient |
880 |
357 |
$32K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
673 |
364 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,354 |
1,908 |
$22K |
| D1110 |
Prophylaxis - adult |
2,362 |
1,755 |
$20K |
| 90674 |
|
1,477 |
784 |
$19K |
| 99442 |
|
1,763 |
876 |
$19K |
| D0120 |
Periodic oral evaluation - established patient |
3,897 |
2,932 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
759 |
411 |
$17K |
| 90651 |
|
671 |
371 |
$15K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,848 |
2,331 |
$14K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
951 |
565 |
$13K |
| D0220 |
Intraoral - periapical first radiographic image |
9,494 |
7,013 |
$13K |
| D0140 |
Limited oral evaluation - problem focused |
2,188 |
1,590 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
418 |
224 |
$12K |
| D0230 |
Intraoral - periapical each additional radiographic image |
8,857 |
5,374 |
$12K |
| D0274 |
Bitewings - four radiographic images |
4,435 |
3,498 |
$11K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
395 |
270 |
$11K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,243 |
2,394 |
$10K |
| 90832 |
Psychotherapy, 30 minutes with patient |
519 |
310 |
$10K |
| 0011A |
|
285 |
278 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
311 |
163 |
$9K |
| 0012A |
|
242 |
237 |
$9K |
| 90686 |
|
1,665 |
1,020 |
$9K |
| 99441 |
|
1,388 |
711 |
$8K |
| 92015 |
Determination of refractive state |
1,065 |
582 |
$7K |
| 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 |
1,434 |
1,156 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
140 |
81 |
$6K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
408 |
244 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
232 |
124 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,067 |
564 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
266 |
139 |
$5K |
| 99383 |
|
133 |
63 |
$4K |
| 99384 |
|
107 |
58 |
$4K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
285 |
158 |
$4K |
| 90688 |
|
391 |
243 |
$4K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
202 |
112 |
$3K |
| 0031A |
|
93 |
88 |
$3K |
| 90677 |
|
16 |
13 |
$3K |
| D1120 |
Prophylaxis - child |
925 |
724 |
$3K |
| 90715 |
|
320 |
199 |
$3K |
| 90619 |
|
239 |
134 |
$3K |
| 99215 |
Prolong outpt/office vis |
75 |
39 |
$3K |
| 96127 |
|
1,011 |
558 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
110 |
68 |
$2K |
| D0272 |
Bitewings - two radiographic images |
1,207 |
937 |
$2K |
| 99173 |
|
1,687 |
862 |
$2K |
| 90656 |
|
106 |
100 |
$2K |
| 96160 |
|
1,473 |
727 |
$2K |
| 90710 |
|
126 |
69 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
26 |
15 |
$1K |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
254 |
93 |
$1K |
| 81025 |
|
349 |
194 |
$1K |
| 90633 |
|
167 |
91 |
$807.10 |
| 99443 |
|
57 |
31 |
$802.74 |
| 0013A |
|
19 |
18 |
$758.89 |
| 90621 |
|
75 |
46 |
$738.30 |
| D0210 |
Intraoral - complete series of radiographic images |
181 |
59 |
$731.84 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
19 |
12 |
$632.17 |
| 90734 |
|
186 |
104 |
$367.64 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
31 |
28 |
$286.63 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
95 |
60 |
$213.28 |
| 96161 |
|
276 |
173 |
$182.78 |
| G0008 |
Administration of influenza virus vaccine |
42 |
27 |
$111.38 |
| 99201 |
|
59 |
45 |
$98.92 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
15 |
14 |
$64.08 |
| 90461 |
|
857 |
418 |
$25.00 |
| 81002 |
|
114 |
88 |
$23.88 |
| 82962 |
|
21 |
12 |
$20.28 |
| 91301 |
|
654 |
639 |
$6.10 |
| 91303 |
|
92 |
87 |
$0.80 |
| 3074F |
|
24,331 |
12,790 |
$0.00 |
| 1036F |
|
24,169 |
12,669 |
$0.00 |
| 3080F |
|
3,050 |
1,522 |
$0.00 |
| D0603 |
|
2,464 |
2,139 |
$0.00 |
| 3079F |
|
12,125 |
6,499 |
$0.00 |
| D0602 |
|
551 |
480 |
$0.00 |
| 3044F |
|
422 |
252 |
$0.00 |
| 3075F |
|
3,931 |
2,116 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
56 |
31 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
79 |
39 |
$0.00 |
| D0601 |
|
13 |
12 |
$0.00 |
| 3078F |
|
17,784 |
9,328 |
$0.00 |
| 4004F |
|
12,764 |
6,642 |
$0.00 |
| 3077F |
|
4,618 |
2,336 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
26 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
23 |
12 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
61 |
32 |
$0.00 |
| 90658 |
|
90 |
49 |
$0.00 |