| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
90,053 |
61,993 |
$8.18M |
| D0999 |
Unspecified diagnostic procedure, by report |
27,004 |
18,521 |
$2.92M |
| H2020 |
Therapeutic behavioral services, per diem |
10,075 |
6,001 |
$754K |
| 99050 |
|
655 |
528 |
$2K |
| 99051 |
|
229 |
171 |
$776.04 |
| 0011A |
|
143 |
77 |
$534.94 |
| 0012A |
|
45 |
21 |
$222.48 |
| 0013A |
|
32 |
12 |
$222.48 |
| 91322 |
|
64 |
22 |
$114.30 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
385 |
229 |
$92.14 |
| D7140 |
Extraction, erupted tooth or exposed root |
9,099 |
4,087 |
$79.07 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
258 |
161 |
$74.79 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
86,635 |
60,507 |
$41.53 |
| 90480 |
|
64 |
22 |
$29.58 |
| D0120 |
Periodic oral evaluation - established patient |
5,693 |
4,781 |
$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 |
13,826 |
9,678 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
6,041 |
4,275 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
6,039 |
4,262 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
5,306 |
3,783 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
3,064 |
2,594 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,767 |
1,225 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
1,064 |
778 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
5,680 |
4,703 |
$0.00 |
| 86803 |
|
1,946 |
1,424 |
$0.00 |
| 84153 |
|
575 |
428 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
9,799 |
8,149 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13,349 |
8,754 |
$0.00 |
| 90673 |
|
143 |
108 |
$0.00 |
| 82962 |
|
5,310 |
3,558 |
$0.00 |
| 86695 |
|
1,189 |
794 |
$0.00 |
| 81001 |
|
1,414 |
933 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,055 |
2,124 |
$0.00 |
| 86592 |
|
1,793 |
1,228 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
984 |
804 |
$0.00 |
| 86804 |
|
170 |
159 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,351 |
2,370 |
$0.00 |
| 91301 |
|
333 |
159 |
$0.00 |
| 87522 |
Neg quan hep c or qual rna |
285 |
237 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
26 |
19 |
$0.00 |
| 91306 |
|
47 |
13 |
$0.00 |
| 99386 |
|
21 |
15 |
$0.00 |
| 3072F |
|
34 |
31 |
$0.00 |
| 99385 |
|
119 |
87 |
$0.00 |
| D4355 |
|
76 |
52 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
74 |
45 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
70 |
45 |
$0.00 |
| 82607 |
|
53 |
34 |
$0.00 |
| 90667 |
|
42 |
28 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
42 |
40 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,636 |
1,209 |
$0.00 |
| D1110 |
Prophylaxis - adult |
5,158 |
4,322 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
10,590 |
8,328 |
$0.00 |
| 11721 |
|
310 |
245 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
1,870 |
1,232 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,769 |
2,846 |
$0.00 |
| 80061 |
Lipid panel |
5,756 |
4,055 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,204 |
896 |
$0.00 |
| D1120 |
Prophylaxis - child |
413 |
394 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,867 |
1,230 |
$0.00 |
| 80074 |
|
2,794 |
1,999 |
$0.00 |
| D0431 |
|
103 |
78 |
$0.00 |
| 81025 |
|
40 |
28 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
263 |
209 |
$0.00 |
| 3078F |
|
16 |
12 |
$0.00 |
| D1999 |
|
42 |
34 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
30 |
18 |
$0.00 |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
12 |
12 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
51 |
28 |
$0.00 |
| D0330 |
Panoramic radiographic image |
16 |
14 |
$0.00 |