| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
178,431 |
139,574 |
$26.08M |
| D9450 |
|
151,010 |
96,261 |
$5.57M |
| 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 |
50,519 |
45,231 |
$3.14M |
| D8670 |
Periodic orthodontic treatment visit |
5,088 |
4,476 |
$1.16M |
| D7140 |
Extraction, erupted tooth or exposed root |
19,926 |
7,288 |
$1.15M |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
5,755 |
1,978 |
$1.08M |
| D1110 |
Prophylaxis - adult |
28,924 |
20,422 |
$1.01M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,738 |
5,599 |
$899K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,773 |
5,714 |
$884K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
16,001 |
7,704 |
$802K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
12,407 |
7,089 |
$789K |
| D1120 |
Prophylaxis - child |
15,110 |
14,693 |
$766K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
5,583 |
5,344 |
$734K |
| D2740 |
Crown - porcelain/ceramic |
1,479 |
919 |
$732K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,418 |
4,104 |
$701K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,491 |
4,351 |
$689K |
| D0120 |
Periodic oral evaluation - established patient |
32,653 |
26,151 |
$641K |
| D1206 |
Topical application of fluoride varnish |
20,769 |
20,188 |
$530K |
| D0210 |
Intraoral - complete series of radiographic images |
11,403 |
7,936 |
$491K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
5,449 |
2,504 |
$465K |
| D0140 |
Limited oral evaluation - problem focused |
15,287 |
11,249 |
$464K |
| D0274 |
Bitewings - four radiographic images |
14,774 |
11,653 |
$405K |
| D1351 |
Sealant - per tooth |
10,213 |
3,615 |
$389K |
| D5212 |
|
1,255 |
801 |
$386K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
11,054 |
8,359 |
$350K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,293 |
2,277 |
$339K |
| D9110 |
|
14,328 |
9,032 |
$335K |
| D0220 |
Intraoral - periapical first radiographic image |
31,390 |
21,180 |
$328K |
| D0330 |
Panoramic radiographic image |
6,460 |
4,924 |
$319K |
| D2330 |
|
5,491 |
2,544 |
$279K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
4,876 |
2,934 |
$278K |
| D2335 |
|
2,759 |
1,504 |
$268K |
| D5211 |
|
973 |
601 |
$266K |
| D2331 |
|
4,309 |
2,246 |
$257K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
5,075 |
2,988 |
$255K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
7,204 |
6,950 |
$249K |
| D2751 |
Crown - porcelain fused to predominantly base metal |
1,163 |
641 |
$248K |
| D5110 |
|
569 |
377 |
$240K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
8,342 |
6,944 |
$235K |
| D2332 |
|
3,189 |
1,627 |
$230K |
| D4341 |
|
3,843 |
1,280 |
$199K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
8,012 |
7,647 |
$182K |
| 99173 |
|
10,624 |
10,560 |
$179K |
| D0230 |
Intraoral - periapical each additional radiographic image |
22,590 |
9,862 |
$177K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17,686 |
16,948 |
$171K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,396 |
3,384 |
$159K |
| D0272 |
Bitewings - two radiographic images |
5,637 |
5,337 |
$155K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
17,426 |
17,114 |
$152K |
| D2954 |
|
1,280 |
894 |
$148K |
| D4342 |
|
3,903 |
1,410 |
$145K |
| 80305 |
|
17,212 |
10,502 |
$145K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
7,490 |
6,953 |
$142K |
| D3320 |
|
398 |
292 |
$131K |
| D3310 |
|
777 |
542 |
$130K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
8,768 |
8,541 |
$113K |
| D0180 |
|
4,324 |
3,253 |
$101K |
| 90677 |
|
932 |
932 |
$97K |
| D8680 |
|
1,097 |
998 |
$96K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
4,665 |
4,075 |
$95K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
4,763 |
4,196 |
$94K |
| 92551 |
|
9,877 |
9,812 |
$92K |
| 90746 |
|
1,392 |
1,388 |
$91K |
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
239 |
173 |
$91K |
| 90686 |
|
10,080 |
10,012 |
$86K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
1,199 |
759 |
$80K |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
68 |
66 |
$79K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
6,681 |
5,672 |
$75K |
| 97803 |
|
1,860 |
1,801 |
$71K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12,639 |
12,165 |
$69K |
| 97802 |
|
918 |
912 |
$68K |
| 92015 |
Determination of refractive state |
5,568 |
5,550 |
$67K |
| 91320 |
|
585 |
554 |
$59K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25,431 |
23,249 |
$53K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,021 |
1,009 |
$52K |
| D2140 |
|
766 |
494 |
$51K |
| 90715 |
|
2,422 |
2,417 |
$50K |
| D0270 |
|
5,349 |
4,028 |
$49K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,583 |
1,547 |
$49K |
| D2394 |
|
692 |
377 |
$42K |
| 99381 |
|
222 |
222 |
$41K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,534 |
13,794 |
$39K |
| 82947 |
|
19,399 |
18,010 |
$39K |
| D1354 |
|
2,794 |
785 |
$38K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
11,428 |
11,264 |
$36K |
| 87634 |
|
530 |
508 |
$33K |
| 90461 |
|
6,105 |
6,068 |
$32K |
| 92341 |
|
882 |
880 |
$30K |
| 81025 |
|
4,103 |
3,969 |
$28K |
| 90688 |
|
2,036 |
2,034 |
$26K |
| D5120 |
|
56 |
39 |
$24K |
| 99188 |
|
896 |
896 |
$23K |
| D7240 |
Removal of impacted tooth - completely bony |
91 |
41 |
$23K |
| 93000 |
|
1,365 |
1,334 |
$22K |
| 90480 |
|
574 |
541 |
$19K |
| 81002 |
|
6,586 |
6,372 |
$18K |
| 0012A |
|
601 |
599 |
$15K |
| 96127 |
|
1,482 |
1,479 |
$15K |
| 0124A |
|
371 |
369 |
$15K |
| D5650 |
|
269 |
116 |
$14K |
| 85018 |
|
6,093 |
6,065 |
$14K |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
95 |
89 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,621 |
1,492 |
$12K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
984 |
961 |
$12K |
| 0064A |
|
281 |
280 |
$12K |
| 0011A |
|
639 |
638 |
$11K |
| D2950 |
|
86 |
64 |
$10K |
| 90732 |
|
108 |
108 |
$9K |
| D8660 |
|
87 |
72 |
$9K |
| D3120 |
|
251 |
182 |
$9K |
| D9248 |
|
303 |
226 |
$9K |
| 0001A |
|
166 |
166 |
$8K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
66 |
43 |
$7K |
| 99050 |
|
741 |
717 |
$7K |
| D9920 |
|
166 |
86 |
$7K |
| 90734 |
|
1,029 |
1,025 |
$7K |
| 87807 |
|
816 |
787 |
$6K |
| 0054A |
|
142 |
142 |
$6K |
| D1330 |
|
2,711 |
2,241 |
$6K |
| 88142 |
|
328 |
326 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
58 |
58 |
$5K |
| 0134A |
|
116 |
116 |
$4K |
| 99384 |
|
24 |
24 |
$4K |
| 97810 |
|
410 |
189 |
$4K |
| D1208 |
Topical application of fluoride, excluding varnish |
210 |
139 |
$4K |
| D7111 |
|
47 |
33 |
$4K |
| D8690 |
|
29 |
27 |
$4K |
| 90707 |
|
510 |
509 |
$4K |
| 90714 |
|
142 |
142 |
$3K |
| 36416 |
|
4,166 |
3,705 |
$3K |
| 90632 |
|
52 |
52 |
$3K |
| 86580 |
|
508 |
474 |
$3K |
| 0004A |
|
62 |
62 |
$3K |
| D8999 |
|
52 |
44 |
$3K |
| 99383 |
|
13 |
13 |
$2K |
| 99382 |
|
13 |
13 |
$2K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
644 |
639 |
$2K |
| 99215 |
Prolong outpt/office vis |
143 |
122 |
$2K |
| 0071A |
|
34 |
34 |
$2K |
| 90670 |
|
1,931 |
1,927 |
$1K |
| D0240 |
|
105 |
76 |
$1K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
207 |
203 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,068 |
1,064 |
$1K |
| 99401 |
|
55 |
55 |
$1K |
| D0273 |
|
43 |
37 |
$1K |
| D8704 |
|
13 |
12 |
$1K |
| D8703 |
|
13 |
12 |
$1K |
| D2160 |
|
26 |
12 |
$946.00 |
| 87210 |
|
177 |
176 |
$915.89 |
| 90832 |
Psychotherapy, 30 minutes with patient |
47 |
42 |
$810.88 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
534 |
458 |
$734.38 |
| D4346 |
|
19 |
15 |
$644.80 |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
14 |
14 |
$630.00 |
| D9310 |
|
86 |
69 |
$589.00 |
| 92134 |
|
33 |
28 |
$588.13 |
| D5612 |
|
17 |
12 |
$539.00 |
| 92133 |
|
23 |
12 |
$322.96 |
| 82274 |
|
13 |
13 |
$198.77 |
| 0031A |
|
39 |
39 |
$113.56 |
| 90716 |
|
446 |
445 |
$69.54 |
| 90662 |
|
304 |
264 |
$65.26 |
| 83986 |
|
14 |
13 |
$39.24 |
| 90474 |
|
80 |
80 |
$26.49 |
| 96160 |
|
262 |
262 |
$12.84 |
| D0190 |
|
143 |
139 |
$3.50 |
| 94760 |
|
4,284 |
4,173 |
$0.46 |
| 90710 |
|
406 |
405 |
$0.00 |
| 90648 |
|
1,077 |
1,076 |
$0.00 |
| 90681 |
|
995 |
992 |
$0.00 |
| 90633 |
|
1,410 |
1,404 |
$0.00 |
| 91300 |
|
2,319 |
2,104 |
$0.00 |
| 99051 |
|
703 |
697 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
354 |
354 |
$0.00 |
| 91312 |
|
646 |
643 |
$0.00 |
| 90661 |
|
366 |
366 |
$0.00 |
| 90687 |
|
100 |
100 |
$0.00 |
| IBUL |
|
28 |
28 |
$0.00 |
| 90700 |
|
344 |
344 |
$0.00 |
| 91311 |
|
30 |
29 |
$0.00 |
| 91313 |
|
145 |
145 |
$0.00 |
| 90672 |
|
16 |
16 |
$0.00 |
| 90619 |
|
521 |
519 |
$0.00 |
| 90723 |
|
672 |
672 |
$0.00 |
| 90651 |
|
2,065 |
2,057 |
$0.00 |
| 90697 |
|
1,037 |
1,032 |
$0.00 |
| 91301 |
|
3,190 |
2,920 |
$0.00 |
| 91307 |
|
944 |
883 |
$0.00 |
| 91303 |
|
152 |
151 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
368 |
368 |
$0.00 |
| 90696 |
|
356 |
355 |
$0.00 |
| D9995 |
|
272 |
167 |
$0.00 |
| D9215 |
|
175 |
156 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
72 |
69 |
$0.00 |
| 91306 |
|
748 |
746 |
$0.00 |
| D1310 |
|
1,076 |
997 |
$0.00 |
| 91305 |
|
847 |
804 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
309 |
294 |
$0.00 |
| D0603 |
|
416 |
355 |
$0.00 |
| D0602 |
|
65 |
55 |
$0.00 |
| 91315 |
|
30 |
29 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
157 |
155 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
16 |
12 |
$0.00 |
| 99000 |
|
17 |
17 |
$0.00 |
| D0601 |
|
13 |
13 |
$0.00 |