| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
89,616 |
68,537 |
$6.41M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
48,048 |
26,027 |
$948K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
19,080 |
10,911 |
$566K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
30,826 |
12,406 |
$376K |
| D7140 |
Extraction, erupted tooth or exposed root |
8,007 |
3,870 |
$288K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
7,913 |
4,383 |
$216K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
9,629 |
5,108 |
$207K |
| D0330 |
Panoramic radiographic image |
9,615 |
7,152 |
$198K |
| 90791 |
Psychiatric diagnostic evaluation |
3,528 |
1,991 |
$163K |
| D1351 |
Sealant - per tooth |
8,222 |
2,153 |
$126K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,229 |
2,361 |
$112K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
8,671 |
6,424 |
$82K |
| D1110 |
Prophylaxis - adult |
4,547 |
3,193 |
$68K |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,642 |
1,971 |
$68K |
| D0140 |
Limited oral evaluation - problem focused |
6,675 |
4,381 |
$67K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,430 |
1,436 |
$64K |
| D1206 |
Topical application of fluoride varnish |
5,237 |
3,684 |
$64K |
| D1120 |
Prophylaxis - child |
6,422 |
4,834 |
$62K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,973 |
1,091 |
$60K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,289 |
687 |
$51K |
| D0120 |
Periodic oral evaluation - established patient |
7,203 |
4,957 |
$50K |
| D1208 |
Topical application of fluoride, excluding varnish |
6,419 |
4,826 |
$29K |
| D1354 |
|
1,865 |
509 |
$28K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,295 |
1,390 |
$25K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
603 |
373 |
$20K |
| D0274 |
Bitewings - four radiographic images |
2,239 |
1,619 |
$19K |
| D0272 |
Bitewings - two radiographic images |
4,127 |
3,114 |
$17K |
| 92551 |
|
2,606 |
1,504 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
244 |
145 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
269 |
152 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
198 |
138 |
$6K |
| 99381 |
|
365 |
216 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
432 |
284 |
$6K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
365 |
263 |
$6K |
| 90671 |
|
1,739 |
1,003 |
$5K |
| 90670 |
|
4,558 |
2,665 |
$5K |
| D2330 |
|
83 |
51 |
$4K |
| 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 |
754 |
687 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
300 |
162 |
$3K |
| 90723 |
|
3,140 |
1,848 |
$3K |
| 0011A |
|
103 |
87 |
$3K |
| 0012A |
|
92 |
76 |
$3K |
| 87590 |
|
264 |
171 |
$2K |
| 87490 |
|
266 |
171 |
$2K |
| 90658 |
|
401 |
219 |
$2K |
| 81025 |
|
682 |
461 |
$2K |
| 90688 |
|
2,053 |
1,228 |
$2K |
| 99383 |
|
86 |
52 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
206 |
139 |
$1K |
| 99215 |
Prolong outpt/office vis |
15 |
15 |
$1K |
| 90651 |
|
702 |
410 |
$1K |
| 99384 |
|
71 |
41 |
$1K |
| 88142 |
|
169 |
131 |
$1K |
| 90710 |
|
1,661 |
935 |
$1K |
| 81003 |
|
1,503 |
805 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
217 |
155 |
$1K |
| 82962 |
|
1,022 |
601 |
$1K |
| 99173 |
|
695 |
460 |
$960.56 |
| D0220 |
Intraoral - periapical first radiographic image |
248 |
156 |
$852.35 |
| 90633 |
|
2,918 |
1,691 |
$759.23 |
| 90785 |
|
296 |
146 |
$712.91 |
| 80305 |
|
152 |
86 |
$669.70 |
| 90661 |
|
394 |
376 |
$657.74 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
22 |
12 |
$634.59 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
151 |
106 |
$612.16 |
| D2140 |
|
15 |
12 |
$578.00 |
| 90656 |
|
62 |
34 |
$520.51 |
| 87210 |
|
246 |
135 |
$493.23 |
| 90734 |
|
872 |
494 |
$489.18 |
| 90647 |
|
2,546 |
1,540 |
$414.04 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
136 |
107 |
$403.75 |
| 90685 |
|
398 |
240 |
$385.61 |
| 99441 |
|
28 |
12 |
$361.40 |
| D2940 |
|
61 |
41 |
$360.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
30 |
28 |
$333.90 |
| 90700 |
|
490 |
275 |
$207.50 |
| 90686 |
|
1,307 |
722 |
$189.46 |
| 90674 |
|
171 |
112 |
$163.59 |
| 90648 |
|
952 |
487 |
$116.18 |
| 90715 |
|
179 |
105 |
$39.27 |
| 90863 |
|
308 |
210 |
$31.99 |
| 90681 |
|
1,272 |
740 |
$0.97 |
| 91301 |
|
174 |
142 |
$0.90 |
| 90713 |
|
63 |
35 |
$0.12 |
| 90707 |
|
76 |
54 |
$0.12 |
| 90716 |
|
68 |
46 |
$0.09 |
| 90744 |
|
36 |
18 |
$0.02 |
| 90680 |
|
39 |
27 |
$0.02 |
| 3077F |
|
5,597 |
3,838 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
25,586 |
16,355 |
$0.00 |
| 3078F |
|
24,370 |
16,422 |
$0.00 |
| 4004F |
|
3,872 |
2,641 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
4,855 |
3,197 |
$0.00 |
| 90687 |
|
139 |
88 |
$0.00 |
| Q2037 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) |
14 |
14 |
$0.00 |
| D0270 |
|
90 |
86 |
$0.00 |
| 1159F |
|
115 |
64 |
$0.00 |
| 3046F |
|
99 |
76 |
$0.00 |
| 99382 |
|
14 |
13 |
$0.00 |
| 3008F |
|
38,337 |
24,463 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
3,186 |
2,067 |
$0.00 |
| 3074F |
|
26,263 |
17,485 |
$0.00 |
| 2001F |
|
38,321 |
24,466 |
$0.00 |
| 1036F |
|
25,583 |
16,760 |
$0.00 |
| 3075F |
|
4,416 |
3,066 |
$0.00 |
| 3079F |
|
9,228 |
6,234 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
27,437 |
17,482 |
$0.00 |
| 3080F |
|
3,008 |
2,033 |
$0.00 |
| 3048F |
|
267 |
185 |
$0.00 |
| D0250 |
|
342 |
314 |
$0.00 |
| 90697 |
|
1,232 |
711 |
$0.00 |
| 90696 |
|
103 |
79 |
$0.00 |
| D0603 |
|
112 |
86 |
$0.00 |
| G0180 |
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care |
17 |
17 |
$0.00 |
| 3044F |
|
67 |
64 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$0.00 |