| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
16,842 |
13,118 |
$2.18M |
| D0999 |
Unspecified diagnostic procedure, by report |
3,878 |
3,532 |
$661K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,816 |
8,361 |
$259K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,611 |
2,414 |
$73K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
921 |
912 |
$53K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
664 |
648 |
$38K |
| 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 |
967 |
835 |
$33K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,142 |
1,991 |
$32K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,290 |
2,158 |
$28K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,098 |
2,938 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
365 |
349 |
$22K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
294 |
293 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
191 |
183 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
429 |
399 |
$3K |
| 81003 |
|
1,798 |
1,343 |
$2K |
| 85027 |
|
735 |
687 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
454 |
434 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
41 |
39 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
333 |
315 |
$1K |
| 87807 |
|
174 |
161 |
$1K |
| 90834 |
Psychotherapy, 45 minutes with patient |
17 |
13 |
$936.70 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,465 |
1,187 |
$662.11 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,238 |
635 |
$632.79 |
| D1110 |
Prophylaxis - adult |
403 |
399 |
$630.01 |
| D0120 |
Periodic oral evaluation - established patient |
1,778 |
1,752 |
$518.46 |
| D0274 |
Bitewings - four radiographic images |
425 |
417 |
$512.32 |
| 81025 |
|
127 |
116 |
$486.94 |
| D0220 |
Intraoral - periapical first radiographic image |
687 |
671 |
$467.02 |
| D0330 |
Panoramic radiographic image |
233 |
230 |
$426.24 |
| 87428 |
|
25 |
25 |
$389.85 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
257 |
248 |
$383.45 |
| D1120 |
Prophylaxis - child |
483 |
479 |
$367.50 |
| 90677 |
|
71 |
70 |
$198.20 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,775 |
1,758 |
$181.75 |
| D1208 |
Topical application of fluoride, excluding varnish |
412 |
410 |
$161.70 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
30 |
30 |
$119.68 |
| 90633 |
|
49 |
49 |
$118.81 |
| 90707 |
|
16 |
16 |
$118.81 |
| 90670 |
|
234 |
234 |
$118.81 |
| 90658 |
|
69 |
67 |
$32.24 |
| D1206 |
Topical application of fluoride varnish |
753 |
741 |
$29.40 |
| 90686 |
|
355 |
341 |
$18.47 |
| 92551 |
|
756 |
733 |
$13.63 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
13 |
12 |
$8.96 |
| 90619 |
|
14 |
13 |
$0.08 |
| 1036F |
|
4,448 |
3,595 |
$0.01 |
| 90688 |
|
88 |
85 |
$0.01 |
| 3078F |
|
4,429 |
3,768 |
$0.00 |
| 1159F |
|
5,885 |
4,836 |
$0.00 |
| 99173 |
|
868 |
835 |
$0.00 |
| 3725F |
|
147 |
140 |
$0.00 |
| 1160F |
|
5,887 |
4,836 |
$0.00 |
| 4013F |
|
41 |
37 |
$0.00 |
| 90662 |
|
12 |
12 |
$0.00 |
| 90648 |
|
14 |
14 |
$0.00 |
| 3077F |
|
15 |
13 |
$0.00 |
| 1091F |
|
22 |
19 |
$0.00 |
| 90687 |
|
13 |
13 |
$0.00 |
| 90671 |
|
12 |
12 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90710 |
|
14 |
14 |
$0.00 |
| 3008F |
|
6,366 |
5,322 |
$0.00 |
| 1126F |
|
4,269 |
3,696 |
$0.00 |
| 1125F |
|
2,125 |
1,908 |
$0.00 |
| D0603 |
|
958 |
947 |
$0.00 |
| D0602 |
|
209 |
206 |
$0.00 |
| 3075F |
|
358 |
331 |
$0.00 |
| D0601 |
|
751 |
742 |
$0.00 |
| 3074F |
|
4,739 |
3,999 |
$0.00 |
| 2001F |
|
6,536 |
5,407 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
28 |
28 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
556 |
533 |
$0.00 |
| 90698 |
|
96 |
96 |
$0.00 |
| 3079F |
|
899 |
799 |
$0.00 |
| 90680 |
|
77 |
77 |
$0.00 |
| 90474 |
|
26 |
26 |
$0.00 |
| 90651 |
|
15 |
15 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
28 |
26 |
$0.00 |
| 3048F |
|
14 |
13 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |
| 90696 |
|
13 |
13 |
$0.00 |
| 90697 |
|
30 |
30 |
$0.00 |
| 90723 |
|
14 |
14 |
$0.00 |