| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
24,276 |
15,057 |
$2.71M |
| H2020 |
Therapeutic behavioral services, per diem |
1,733 |
588 |
$162K |
| D7140 |
Extraction, erupted tooth or exposed root |
116 |
64 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
171 |
126 |
$6K |
| D0330 |
Panoramic radiographic image |
119 |
100 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
97 |
55 |
$2K |
| D1110 |
Prophylaxis - adult |
61 |
42 |
$2K |
| D0272 |
Bitewings - two radiographic images |
123 |
97 |
$662.60 |
| D0220 |
Intraoral - periapical first radiographic image |
94 |
52 |
$637.91 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,517 |
11,493 |
$421.97 |
| 3074F |
|
2,717 |
2,067 |
$245.00 |
| 3078F |
|
2,019 |
1,591 |
$180.00 |
| 3079F |
|
1,625 |
1,293 |
$165.00 |
| 98960 |
|
97 |
35 |
$108.00 |
| 3075F |
|
593 |
517 |
$95.00 |
| 3077F |
|
533 |
425 |
$40.00 |
| 3080F |
|
317 |
245 |
$20.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
834 |
698 |
$1.12 |
| 3008F |
|
7,787 |
5,522 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
616 |
436 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
270 |
226 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
2,030 |
948 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
654 |
475 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
387 |
324 |
$0.00 |
| J1094 |
Injection, dexamethasone acetate, 1 mg |
123 |
103 |
$0.00 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
18 |
12 |
$0.00 |
| 85018 |
|
39 |
34 |
$0.00 |
| 92551 |
|
54 |
44 |
$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 |
105 |
68 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
15 |
13 |
$0.00 |
| 82962 |
|
37 |
32 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
14 |
14 |
$0.00 |
| 81025 |
|
1,311 |
1,084 |
$0.00 |
| 81002 |
|
511 |
439 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
575 |
521 |
$0.00 |
| 82948 |
|
294 |
212 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,250 |
1,235 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,737 |
2,152 |
$0.00 |
| J7637 |
Dexamethasone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram |
30 |
28 |
$0.00 |
| 99173 |
|
177 |
137 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
64 |
51 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
15 |
14 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
15 |
13 |
$0.00 |