| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
51,547 |
45,394 |
$9.88M |
| 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 |
9,512 |
8,700 |
$310K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,181 |
432 |
$76K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,449 |
20,093 |
$67K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,541 |
8,006 |
$57K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
500 |
379 |
$46K |
| D9999 |
Unspecified adjunctive procedure, by report |
213 |
208 |
$46K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
464 |
329 |
$27K |
| D0140 |
Limited oral evaluation - problem focused |
723 |
719 |
$22K |
| 99441 |
|
602 |
577 |
$19K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
343 |
320 |
$9K |
| D0220 |
Intraoral - periapical first radiographic image |
509 |
507 |
$8K |
| 98968 |
|
200 |
88 |
$7K |
| 99442 |
|
93 |
93 |
$5K |
| D4341 |
|
28 |
12 |
$4K |
| G0179 |
Physician or allowed practitioner re-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 |
233 |
233 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
61 |
52 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
505 |
503 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
203 |
200 |
$400.33 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
82 |
82 |
$296.64 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$205.80 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$191.36 |
| D0603 |
|
661 |
661 |
$164.70 |
| D0601 |
|
123 |
123 |
$64.05 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
818 |
818 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
1,905 |
1,905 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
3,596 |
3,596 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
313 |
313 |
$0.00 |
| D0602 |
|
152 |
152 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
2,700 |
2,700 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
20 |
20 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
119 |
117 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$0.00 |
| D1351 |
Sealant - per tooth |
33 |
12 |
$0.00 |
| D1110 |
Prophylaxis - adult |
1,244 |
1,244 |
$0.00 |
| D0330 |
Panoramic radiographic image |
881 |
881 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
31 |
31 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
1,874 |
1,874 |
$0.00 |
| D1120 |
Prophylaxis - child |
2,561 |
2,561 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
52 |
52 |
$0.00 |
| D4910 |
|
12 |
12 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$0.00 |