| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
95,594 |
88,647 |
$19.98M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
71,266 |
66,053 |
$2.54M |
| 90834 |
Psychotherapy, 45 minutes with patient |
17,294 |
11,034 |
$1.66M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
32,494 |
30,710 |
$1.61M |
| 90837 |
Psychotherapy, 53 minutes with patient |
13,139 |
7,660 |
$1.30M |
| D0120 |
Periodic oral evaluation - established patient |
32,513 |
32,361 |
$836K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
11,117 |
8,802 |
$734K |
| D1206 |
Topical application of fluoride varnish |
45,322 |
45,103 |
$724K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
9,372 |
7,172 |
$508K |
| 90832 |
Psychotherapy, 30 minutes with patient |
7,866 |
6,010 |
$481K |
| D1120 |
Prophylaxis - child |
17,307 |
17,235 |
$399K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
12,880 |
12,179 |
$298K |
| D1351 |
Sealant - per tooth |
15,184 |
6,084 |
$290K |
| D1110 |
Prophylaxis - adult |
6,728 |
6,694 |
$283K |
| D0274 |
Bitewings - four radiographic images |
18,072 |
17,932 |
$188K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,832 |
4,782 |
$180K |
| D0330 |
Panoramic radiographic image |
3,953 |
3,909 |
$155K |
| 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 |
16,217 |
13,690 |
$150K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
1,793 |
867 |
$134K |
| D0190 |
|
10,755 |
10,746 |
$110K |
| D0220 |
Intraoral - periapical first radiographic image |
12,533 |
12,368 |
$110K |
| 99215 |
Prolong outpt/office vis |
1,064 |
1,029 |
$94K |
| D0272 |
Bitewings - two radiographic images |
9,057 |
9,031 |
$84K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,741 |
2,630 |
$81K |
| 90686 |
|
5,114 |
5,083 |
$65K |
| D0230 |
Intraoral - periapical each additional radiographic image |
25,402 |
8,758 |
$59K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
481 |
464 |
$58K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
672 |
618 |
$55K |
| 0002A |
|
1,252 |
1,247 |
$49K |
| D1999 |
|
3,789 |
3,672 |
$49K |
| 0001A |
|
1,251 |
1,250 |
$46K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,464 |
5,397 |
$46K |
| D0140 |
Limited oral evaluation - problem focused |
1,547 |
1,504 |
$33K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
391 |
389 |
$25K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,254 |
1,070 |
$19K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
832 |
806 |
$18K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
264 |
154 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
231 |
231 |
$13K |
| 0003A |
|
323 |
323 |
$13K |
| 90791 |
Psychiatric diagnostic evaluation |
54 |
54 |
$12K |
| D7140 |
Extraction, erupted tooth or exposed root |
239 |
129 |
$11K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,335 |
456 |
$10K |
| 90677 |
|
46 |
45 |
$10K |
| H0001 |
Alcohol and/or drug assessment |
59 |
59 |
$9K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
213 |
211 |
$8K |
| 90682 |
|
171 |
171 |
$8K |
| 96127 |
|
1,490 |
1,438 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
52 |
51 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
97 |
97 |
$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 |
360 |
232 |
$6K |
| 87428 |
|
95 |
94 |
$5K |
| 0071A |
|
124 |
123 |
$5K |
| 96165 |
|
136 |
51 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
76 |
74 |
$4K |
| 0031A |
|
81 |
81 |
$3K |
| 0072A |
|
81 |
81 |
$3K |
| 0124A |
|
76 |
76 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
51 |
48 |
$3K |
| 96164 |
|
136 |
51 |
$3K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
24 |
14 |
$3K |
| 99443 |
|
43 |
41 |
$2K |
| 99442 |
|
59 |
55 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
26 |
26 |
$2K |
| H0031 |
Mental health assessment, by non-physician |
449 |
364 |
$2K |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
585 |
581 |
$1K |
| D2331 |
|
16 |
13 |
$1K |
| 90651 |
|
131 |
130 |
$915.65 |
| D2330 |
|
15 |
12 |
$890.55 |
| 99441 |
|
33 |
33 |
$740.06 |
| 90688 |
|
107 |
106 |
$653.89 |
| 90633 |
|
119 |
117 |
$652.78 |
| 93000 |
|
76 |
76 |
$586.60 |
| 0053A |
|
14 |
14 |
$560.00 |
| 90670 |
|
96 |
95 |
$553.48 |
| 17000 |
|
15 |
15 |
$542.70 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
148 |
144 |
$483.09 |
| 0054A |
|
12 |
12 |
$480.00 |
| 90715 |
|
48 |
48 |
$419.11 |
| 90685 |
|
29 |
29 |
$418.20 |
| 20552 |
|
14 |
12 |
$368.34 |
| 90734 |
|
58 |
58 |
$337.29 |
| 90744 |
|
28 |
28 |
$208.77 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
16 |
$202.95 |
| 17003 |
|
12 |
12 |
$150.96 |
| 90707 |
|
13 |
13 |
$148.08 |
| 90698 |
|
24 |
24 |
$144.22 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
115 |
115 |
$133.69 |
| 81003 |
|
68 |
66 |
$115.04 |
| 81025 |
|
12 |
12 |
$67.64 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$66.42 |
| 90785 |
|
19 |
12 |
$7.44 |
| 3074F |
|
22,850 |
21,644 |
$0.00 |
| 3079F |
|
8,124 |
7,832 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
754 |
749 |
$0.00 |
| D0603 |
|
3,340 |
3,326 |
$0.00 |
| 3075F |
|
2,224 |
2,164 |
$0.00 |
| 3080F |
|
191 |
178 |
$0.00 |
| 3008F |
|
731 |
717 |
$0.00 |
| 91307 |
|
243 |
233 |
$0.00 |
| 91301 |
|
18 |
13 |
$0.00 |
| 91305 |
|
96 |
89 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
12 |
12 |
$0.00 |
| 91303 |
|
67 |
67 |
$0.00 |
| 3078F |
|
19,953 |
18,949 |
$0.00 |
| 91300 |
|
2,692 |
2,284 |
$0.00 |
| 3077F |
|
1,791 |
1,697 |
$0.00 |
| 90662 |
|
225 |
223 |
$0.00 |
| 91312 |
|
76 |
76 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
846 |
826 |
$0.00 |
| 99072 |
|
21 |
19 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
16 |
12 |
$0.00 |