| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
71,129 |
48,214 |
$4.57M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,564 |
10,915 |
$420K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
38,444 |
8,029 |
$257K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,070 |
3,954 |
$206K |
| D1110 |
Prophylaxis - adult |
9,685 |
5,495 |
$174K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
3,146 |
2,184 |
$165K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
9,495 |
5,433 |
$137K |
| D7140 |
Extraction, erupted tooth or exposed root |
3,749 |
1,336 |
$126K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
4,236 |
1,962 |
$122K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,912 |
959 |
$109K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
12,079 |
2,626 |
$106K |
| D1120 |
Prophylaxis - child |
9,211 |
5,149 |
$106K |
| D0210 |
Intraoral - complete series of radiographic images |
3,129 |
1,905 |
$104K |
| D0120 |
Periodic oral evaluation - established patient |
10,380 |
5,789 |
$99K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,986 |
1,648 |
$87K |
| D0140 |
Limited oral evaluation - problem focused |
6,919 |
3,772 |
$81K |
| D1208 |
Topical application of fluoride, excluding varnish |
9,721 |
5,319 |
$73K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,180 |
1,009 |
$62K |
| D0274 |
Bitewings - four radiographic images |
5,606 |
3,282 |
$53K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,860 |
2,113 |
$44K |
| D0330 |
Panoramic radiographic image |
2,276 |
1,380 |
$40K |
| D1351 |
Sealant - per tooth |
1,353 |
311 |
$25K |
| D1206 |
Topical application of fluoride varnish |
757 |
683 |
$21K |
| 80305 |
|
4,095 |
1,847 |
$19K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,262 |
1,812 |
$18K |
| 90651 |
|
2,342 |
1,326 |
$18K |
| D0220 |
Intraoral - periapical first radiographic image |
6,299 |
3,452 |
$17K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
508 |
251 |
$16K |
| 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 |
567 |
476 |
$15K |
| 90686 |
|
4,193 |
2,259 |
$15K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,820 |
992 |
$15K |
| 91322 |
|
169 |
132 |
$12K |
| 0001A |
|
324 |
315 |
$12K |
| 0002A |
|
297 |
293 |
$11K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
278 |
132 |
$9K |
| 81025 |
|
2,726 |
1,561 |
$8K |
| 90480 |
|
246 |
186 |
$7K |
| 90670 |
|
4,044 |
2,379 |
$6K |
| D0272 |
Bitewings - two radiographic images |
849 |
513 |
$6K |
| 90791 |
Psychiatric diagnostic evaluation |
160 |
69 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
762 |
516 |
$5K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
812 |
452 |
$4K |
| D0270 |
|
1,881 |
970 |
$4K |
| 0012A |
|
132 |
128 |
$4K |
| 0071A |
|
106 |
92 |
$4K |
| 90734 |
|
2,291 |
1,204 |
$4K |
| 90648 |
|
4,999 |
2,934 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
143 |
75 |
$4K |
| 0072A |
|
77 |
76 |
$4K |
| 90834 |
Psychotherapy, 45 minutes with patient |
164 |
41 |
$4K |
| 90715 |
|
1,385 |
764 |
$3K |
| 81002 |
|
3,662 |
1,868 |
$3K |
| 90707 |
|
777 |
473 |
$3K |
| 90620 |
|
689 |
350 |
$3K |
| 0011A |
|
160 |
154 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
2,863 |
1,699 |
$3K |
| 90716 |
|
676 |
415 |
$3K |
| 80354 |
|
859 |
324 |
$3K |
| 90633 |
|
3,175 |
1,877 |
$3K |
| 90723 |
|
2,689 |
1,568 |
$2K |
| 90632 |
|
87 |
39 |
$2K |
| 99382 |
|
46 |
24 |
$2K |
| 90700 |
|
2,131 |
1,243 |
$2K |
| 90681 |
|
1,546 |
884 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
59 |
54 |
$1K |
| 0064A |
|
38 |
37 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
50 |
27 |
$1K |
| 0004A |
|
30 |
29 |
$1K |
| 0031A |
|
30 |
30 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
484 |
184 |
$1K |
| 99215 |
Prolong outpt/office vis |
45 |
32 |
$1K |
| 90713 |
|
781 |
454 |
$838.50 |
| 36416 |
|
523 |
328 |
$750.47 |
| 90710 |
|
677 |
382 |
$650.02 |
| 90677 |
|
234 |
170 |
$492.41 |
| 90696 |
|
497 |
280 |
$490.00 |
| 0124A |
|
25 |
13 |
$459.44 |
| 0054A |
|
12 |
12 |
$414.26 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
21 |
13 |
$349.45 |
| 90656 |
|
65 |
62 |
$290.56 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
27 |
13 |
$147.30 |
| 90685 |
|
119 |
111 |
$113.00 |
| 85018 |
|
75 |
39 |
$61.98 |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
390 |
205 |
$22.66 |
| 90671 |
|
528 |
275 |
$16.64 |
| 91301 |
|
304 |
289 |
$0.18 |
| 91312 |
|
22 |
13 |
$0.09 |
| 91305 |
|
48 |
43 |
$0.08 |
| 91307 |
|
188 |
160 |
$0.02 |
| 1160F |
|
1,532 |
1,066 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
392 |
268 |
$0.00 |
| 4004F |
|
468 |
350 |
$0.00 |
| 91300 |
|
678 |
618 |
$0.00 |
| 1159F |
|
1,532 |
1,066 |
$0.00 |
| 3078F |
|
439 |
315 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
16 |
14 |
$0.00 |
| D1999 |
|
291 |
244 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
295 |
262 |
$0.00 |
| 3074F |
|
886 |
633 |
$0.00 |
| 3079F |
|
572 |
395 |
$0.00 |
| D0602 |
|
12 |
12 |
$0.00 |
| 3048F |
|
24 |
24 |
$0.00 |
| 1036F |
|
204 |
151 |
$0.00 |
| 3075F |
|
132 |
100 |
$0.00 |
| 91303 |
|
40 |
40 |
$0.00 |
| D1310 |
|
94 |
88 |
$0.00 |
| 3008F |
|
44 |
29 |
$0.00 |
| D9995 |
|
13 |
12 |
$0.00 |
| 3049F |
|
14 |
13 |
$0.00 |