| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
36,162 |
31,982 |
$5.47M |
| D9450 |
|
26,908 |
17,899 |
$592K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,336 |
3,267 |
$479K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,973 |
2,965 |
$427K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,258 |
2,257 |
$346K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,912 |
1,906 |
$308K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,340 |
2,171 |
$263K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,441 |
1,440 |
$216K |
| D9110 |
|
5,305 |
2,613 |
$114K |
| D1110 |
Prophylaxis - adult |
8,101 |
6,357 |
$110K |
| 90677 |
|
721 |
721 |
$94K |
| 90746 |
|
1,216 |
1,212 |
$80K |
| 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 |
2,212 |
1,983 |
$74K |
| D0220 |
Intraoral - periapical first radiographic image |
7,915 |
4,310 |
$69K |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
469 |
388 |
$65K |
| 99050 |
|
1,299 |
1,271 |
$64K |
| D0210 |
Intraoral - complete series of radiographic images |
3,491 |
2,698 |
$52K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,202 |
1,180 |
$52K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,221 |
991 |
$51K |
| 90686 |
|
3,694 |
3,686 |
$50K |
| 91320 |
|
446 |
446 |
$50K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
3,441 |
2,040 |
$42K |
| D0120 |
Periodic oral evaluation - established patient |
5,706 |
4,630 |
$42K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,357 |
9,247 |
$40K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,943 |
2,567 |
$37K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,058 |
1,537 |
$36K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,608 |
1,321 |
$31K |
| D1120 |
Prophylaxis - child |
562 |
535 |
$28K |
| 90480 |
|
616 |
615 |
$28K |
| 90750 |
|
565 |
563 |
$26K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
201 |
199 |
$26K |
| D0274 |
Bitewings - four radiographic images |
2,347 |
1,897 |
$25K |
| 90715 |
|
842 |
842 |
$24K |
| 0012A |
|
513 |
512 |
$24K |
| D0140 |
Limited oral evaluation - problem focused |
1,111 |
590 |
$23K |
| 0011A |
|
492 |
489 |
$22K |
| 99381 |
|
116 |
116 |
$22K |
| 0124A |
|
495 |
493 |
$21K |
| 90791 |
Psychiatric diagnostic evaluation |
150 |
149 |
$19K |
| D1206 |
Topical application of fluoride varnish |
726 |
681 |
$18K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,833 |
1,774 |
$18K |
| 81025 |
|
2,145 |
2,109 |
$15K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,912 |
3,890 |
$13K |
| 99385 |
|
65 |
65 |
$13K |
| 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 |
121 |
89 |
$13K |
| 90651 |
|
585 |
583 |
$12K |
| 99402 |
|
194 |
193 |
$11K |
| 99173 |
|
736 |
736 |
$11K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,695 |
1,688 |
$11K |
| 90707 |
|
369 |
369 |
$9K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
114 |
113 |
$8K |
| 99188 |
|
273 |
273 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
485 |
478 |
$6K |
| 90739 |
|
46 |
45 |
$6K |
| D2330 |
|
360 |
204 |
$6K |
| 96127 |
|
522 |
511 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,473 |
2,460 |
$5K |
| 81000 |
|
1,215 |
1,191 |
$4K |
| 85018 |
|
1,374 |
1,359 |
$3K |
| 92551 |
|
323 |
320 |
$3K |
| 90670 |
|
240 |
237 |
$2K |
| D1351 |
Sealant - per tooth |
38 |
12 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
423 |
372 |
$1K |
| 90716 |
|
195 |
193 |
$1K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
71 |
38 |
$1K |
| 99443 |
|
73 |
72 |
$1K |
| 0154A |
|
60 |
60 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,065 |
1,009 |
$936.46 |
| 90461 |
|
1,343 |
1,337 |
$777.36 |
| 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 |
13 |
13 |
$740.74 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
52 |
41 |
$705.00 |
| 99442 |
|
100 |
99 |
$665.92 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
52 |
51 |
$578.76 |
| D0270 |
|
117 |
102 |
$463.00 |
| 81003 |
|
222 |
219 |
$437.58 |
| D1354 |
|
36 |
20 |
$360.00 |
| D2331 |
|
18 |
13 |
$184.00 |
| 82947 |
|
25 |
24 |
$95.61 |
| D3120 |
|
41 |
25 |
$68.00 |
| 91318 |
|
103 |
102 |
$65.36 |
| 0054A |
|
29 |
29 |
$55.35 |
| 90474 |
|
446 |
443 |
$35.32 |
| 90680 |
|
475 |
474 |
$0.00 |
| 91301 |
|
1,212 |
1,190 |
$0.00 |
| 36416 |
|
716 |
708 |
$0.00 |
| 90697 |
|
390 |
390 |
$0.00 |
| 90619 |
|
54 |
54 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
964 |
952 |
$0.00 |
| 91315 |
|
79 |
78 |
$0.00 |
| 91305 |
|
84 |
84 |
$0.00 |
| 91307 |
|
31 |
29 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90723 |
|
120 |
118 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
45 |
45 |
$0.00 |
| 90694 |
|
16 |
16 |
$0.00 |
| D0180 |
|
17 |
13 |
$0.00 |
| 90633 |
|
366 |
365 |
$0.00 |
| 90648 |
|
167 |
163 |
$0.00 |
| 91312 |
|
319 |
319 |
$0.00 |
| 91308 |
|
99 |
92 |
$0.00 |
| 90700 |
|
15 |
15 |
$0.00 |
| 90473 |
|
16 |
16 |
$0.00 |