| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
54,688 |
31,974 |
$2.96M |
| 90837 |
Psychotherapy, 53 minutes with patient |
11,228 |
2,963 |
$361K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,696 |
6,114 |
$215K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,162 |
4,030 |
$207K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12,121 |
2,954 |
$100K |
| D1110 |
Prophylaxis - adult |
6,687 |
4,259 |
$91K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,690 |
1,265 |
$80K |
| D0120 |
Periodic oral evaluation - established patient |
7,686 |
4,783 |
$58K |
| D1120 |
Prophylaxis - child |
6,568 |
4,087 |
$57K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,937 |
975 |
$52K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,237 |
1,095 |
$49K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
5,300 |
3,332 |
$47K |
| D1208 |
Topical application of fluoride, excluding varnish |
7,087 |
4,414 |
$44K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,672 |
804 |
$32K |
| D0274 |
Bitewings - four radiographic images |
4,031 |
2,573 |
$30K |
| D0140 |
Limited oral evaluation - problem focused |
3,465 |
2,154 |
$23K |
| D0330 |
Panoramic radiographic image |
1,444 |
851 |
$22K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,310 |
411 |
$20K |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
18 |
12 |
$15K |
| D1351 |
Sealant - per tooth |
1,487 |
299 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,268 |
725 |
$11K |
| D0272 |
Bitewings - two radiographic images |
2,781 |
1,744 |
$9K |
| D0220 |
Intraoral - periapical first radiographic image |
5,351 |
3,387 |
$8K |
| 90734 |
|
1,023 |
516 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
824 |
470 |
$7K |
| 90651 |
|
266 |
139 |
$7K |
| 90791 |
Psychiatric diagnostic evaluation |
168 |
83 |
$6K |
| 90686 |
|
1,194 |
642 |
$6K |
| 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 |
169 |
75 |
$6K |
| 0002A |
|
228 |
164 |
$6K |
| 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 |
230 |
187 |
$6K |
| Q3014 |
Telehealth originating site facility fee |
980 |
312 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
477 |
247 |
$6K |
| 0001A |
|
201 |
126 |
$5K |
| D1206 |
Topical application of fluoride varnish |
674 |
340 |
$5K |
| 99406 |
|
1,201 |
559 |
$5K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
186 |
93 |
$5K |
| 90710 |
|
172 |
85 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,660 |
1,494 |
$4K |
| 0004A |
|
152 |
85 |
$3K |
| 90715 |
|
727 |
375 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
160 |
106 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
163 |
82 |
$3K |
| 90633 |
|
285 |
153 |
$2K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
114 |
55 |
$2K |
| 0072A |
|
87 |
50 |
$2K |
| 0071A |
|
102 |
51 |
$2K |
| 90688 |
|
507 |
212 |
$2K |
| 90480 |
|
70 |
46 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
74 |
39 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
142 |
79 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
1,038 |
533 |
$1K |
| 90620 |
|
28 |
12 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
101 |
49 |
$1K |
| 90746 |
|
32 |
18 |
$968.32 |
| 0124A |
|
68 |
32 |
$950.90 |
| 90632 |
|
35 |
16 |
$741.79 |
| 0031A |
|
13 |
13 |
$525.38 |
| 0011A |
|
32 |
32 |
$463.33 |
| 87430 |
|
61 |
25 |
$318.18 |
| 90696 |
|
61 |
30 |
$298.76 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
76 |
34 |
$277.02 |
| 90670 |
|
151 |
87 |
$209.01 |
| 91320 |
|
30 |
15 |
$131.21 |
| 81025 |
|
27 |
12 |
$98.18 |
| 90700 |
|
58 |
25 |
$90.00 |
| D0270 |
|
75 |
38 |
$84.00 |
| 90656 |
|
29 |
29 |
$68.13 |
| 90648 |
|
192 |
104 |
$65.46 |
| 90723 |
|
55 |
27 |
$10.01 |
| 91300 |
|
817 |
494 |
$4.70 |
| 91307 |
|
194 |
101 |
$0.91 |
| 91312 |
|
79 |
36 |
$0.30 |
| 91301 |
|
32 |
32 |
$0.27 |
| 91303 |
|
13 |
13 |
$0.12 |
| 3008F |
|
15,340 |
7,200 |
$0.01 |
| 90461 |
|
509 |
276 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
583 |
314 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
39 |
20 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
152 |
87 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
28 |
17 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
27 |
14 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
707 |
360 |
$0.00 |
| 3074F |
|
1,089 |
560 |
$0.00 |
| 99000 |
|
404 |
301 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
327 |
175 |
$0.00 |
| D0603 |
|
126 |
79 |
$0.00 |
| G9717 |
Documentation stating the patient has had a diagnosis of bipolar disorder |
20 |
12 |
$0.00 |
| 1036F |
|
17 |
12 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
313 |
156 |
$0.00 |
| G8542 |
Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required |
199 |
173 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
57 |
30 |
$0.00 |
| D0602 |
|
91 |
52 |
$0.00 |
| G8430 |
Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status) |
24 |
12 |
$0.00 |
| 3075F |
|
21 |
12 |
$0.00 |