| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
67,254 |
54,479 |
$17.91M |
| D9999 |
Unspecified adjunctive procedure, by report |
30,035 |
27,081 |
$7.21M |
| D0999 |
Unspecified diagnostic procedure, by report |
15,059 |
13,605 |
$3.53M |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
4,356 |
4,190 |
$219K |
| 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 |
3,163 |
2,774 |
$190K |
| D0210 |
Intraoral - complete series of radiographic images |
7,527 |
7,357 |
$63K |
| D1110 |
Prophylaxis - adult |
12,463 |
12,251 |
$59K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
3,725 |
3,006 |
$46K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
6,584 |
6,452 |
$29K |
| D1206 |
Topical application of fluoride varnish |
17,625 |
17,336 |
$27K |
| D1120 |
Prophylaxis - child |
6,086 |
5,964 |
$27K |
| D0120 |
Periodic oral evaluation - established patient |
6,892 |
6,782 |
$26K |
| D0140 |
Limited oral evaluation - problem focused |
7,297 |
7,110 |
$23K |
| D1999 |
|
109 |
102 |
$22K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,911 |
1,546 |
$21K |
| D0274 |
Bitewings - four radiographic images |
5,001 |
4,898 |
$20K |
| D0603 |
|
7,579 |
7,502 |
$18K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,842 |
1,241 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25,003 |
22,751 |
$12K |
| D0220 |
Intraoral - periapical first radiographic image |
8,020 |
7,807 |
$10K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
354 |
320 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,940 |
14,823 |
$9K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
110 |
83 |
$8K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
431 |
363 |
$7K |
| D0270 |
|
2,774 |
2,726 |
$3K |
| 90837 |
Psychotherapy, 53 minutes with patient |
5,172 |
3,763 |
$3K |
| D1351 |
Sealant - per tooth |
1,107 |
384 |
$2K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
233 |
182 |
$2K |
| D5110 |
|
17 |
12 |
$2K |
| 3074F |
|
3,312 |
2,930 |
$2K |
| D0602 |
|
1,680 |
1,653 |
$1K |
| 3079F |
|
1,342 |
1,218 |
$1K |
| D0272 |
Bitewings - two radiographic images |
444 |
430 |
$1K |
| 3078F |
|
2,702 |
2,433 |
$1K |
| 99215 |
Prolong outpt/office vis |
1,062 |
1,000 |
$1K |
| D0330 |
Panoramic radiographic image |
167 |
162 |
$1K |
| 3077F |
|
533 |
491 |
$840.00 |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
101 |
68 |
$803.77 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
850 |
824 |
$797.88 |
| 3075F |
|
691 |
645 |
$780.00 |
| 3044F |
|
138 |
134 |
$760.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,868 |
1,552 |
$606.29 |
| D0230 |
Intraoral - periapical each additional radiographic image |
776 |
556 |
$564.34 |
| D2330 |
|
23 |
16 |
$442.79 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
916 |
905 |
$389.25 |
| 81025 |
|
850 |
763 |
$340.86 |
| D0240 |
|
151 |
80 |
$322.63 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,272 |
3,196 |
$322.26 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,293 |
1,233 |
$253.36 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
262 |
245 |
$227.83 |
| 90791 |
Psychiatric diagnostic evaluation |
673 |
652 |
$199.95 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,101 |
966 |
$195.13 |
| 36415 |
Collection of venous blood by venipuncture |
10,544 |
10,097 |
$166.61 |
| D2331 |
|
35 |
24 |
$148.49 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
924 |
889 |
$125.58 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
503 |
481 |
$117.82 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
291 |
283 |
$58.62 |
| 99201 |
|
13 |
12 |
$55.23 |
| 86703 |
|
540 |
525 |
$54.28 |
| 96160 |
|
1,103 |
1,058 |
$49.14 |
| 90686 |
|
1,027 |
1,007 |
$35.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
802 |
747 |
$18.85 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,361 |
1,327 |
$15.27 |
| D0601 |
|
15 |
15 |
$15.00 |
| 81003 |
|
1,049 |
984 |
$3.15 |
| D1354 |
|
59 |
17 |
$0.23 |
| 99417 |
Prolong home eval add 15m |
57 |
54 |
$0.00 |
| 3080F |
|
509 |
474 |
$0.00 |
| 99383 |
|
151 |
138 |
$0.00 |
| 1125F |
|
400 |
372 |
$0.00 |
| 1126F |
|
434 |
415 |
$0.00 |
| 2000F |
|
4,643 |
4,017 |
$0.00 |
| 2010F |
|
5,645 |
4,763 |
$0.00 |
| G0506 |
Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) |
294 |
290 |
$0.00 |
| 99384 |
|
46 |
41 |
$0.00 |
| 36416 |
|
722 |
699 |
$0.00 |
| 3351F |
|
1,900 |
1,773 |
$0.00 |
| 90651 |
|
234 |
220 |
$0.00 |
| 2001F |
|
5,253 |
4,470 |
$0.00 |
| 4037F |
|
443 |
436 |
$0.00 |
| D9995 |
|
42 |
42 |
$0.00 |
| 1036F |
|
3,485 |
2,937 |
$0.00 |
| 4010F |
|
761 |
572 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
542 |
513 |
$0.00 |
| 3353F |
|
214 |
204 |
$0.00 |
| 86803 |
|
111 |
107 |
$0.00 |
| 1034F |
|
1,566 |
1,273 |
$0.00 |
| 99439 |
|
85 |
83 |
$0.00 |
| 90619 |
|
93 |
87 |
$0.00 |
| 3352F |
|
382 |
368 |
$0.00 |
| 3008F |
|
5,105 |
4,361 |
$0.00 |
| Q2036 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) |
206 |
205 |
$0.00 |
| 90677 |
|
13 |
13 |
$0.00 |
| 99443 |
|
267 |
259 |
$0.00 |
| 85018 |
|
16 |
15 |
$0.00 |
| 90656 |
|
382 |
375 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90697 |
|
14 |
14 |
$0.00 |
| 99441 |
|
13 |
13 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12 |
12 |
$0.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
12 |
12 |
$0.00 |
| 90716 |
|
13 |
12 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
106 |
105 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
547 |
539 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
303 |
297 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,236 |
2,125 |
$0.00 |
| 1159F |
|
4,864 |
4,106 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
674 |
645 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
581 |
561 |
$0.00 |
| 90715 |
|
452 |
440 |
$0.00 |
| 90671 |
|
60 |
57 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
151 |
128 |
$0.00 |
| 1160F |
|
4,864 |
4,106 |
$0.00 |
| 90461 |
|
1,024 |
967 |
$0.00 |
| 99442 |
|
326 |
318 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
50 |
50 |
$0.00 |
| 90633 |
|
146 |
141 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
426 |
411 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
358 |
345 |
$0.00 |
| 4274F |
|
1,643 |
1,217 |
$0.00 |
| 2028F |
|
54 |
54 |
$0.00 |
| 0124A |
|
77 |
76 |
$0.00 |
| 4040F |
|
495 |
390 |
$0.00 |
| 99408 |
|
27 |
26 |
$0.00 |
| 3046F |
|
12 |
12 |
$0.00 |
| 90750 |
|
53 |
53 |
$0.00 |
| 4004F |
|
1,259 |
1,154 |
$0.00 |
| 83721 |
|
17 |
17 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 90734 |
|
25 |
25 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12 |
12 |
$0.00 |
| 90649 |
|
14 |
14 |
$0.00 |