| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
87,061 |
54,514 |
$8.24M |
| H2020 |
Therapeutic behavioral services, per diem |
11,680 |
5,034 |
$717K |
| D0999 |
Unspecified diagnostic procedure, by report |
3,180 |
1,590 |
$201K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,396 |
721 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,335 |
5,192 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
54,352 |
36,672 |
$1K |
| D0330 |
Panoramic radiographic image |
716 |
440 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
616 |
377 |
$577.68 |
| D1110 |
Prophylaxis - adult |
204 |
108 |
$260.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
2,365 |
1,105 |
$229.86 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
194 |
142 |
$156.22 |
| 99051 |
|
17 |
15 |
$126.80 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
465 |
319 |
$58.42 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
719 |
594 |
$49.74 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
11,815 |
7,495 |
$30.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
397 |
302 |
$21.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
725 |
550 |
$14.70 |
| 81003 |
|
10,631 |
7,780 |
$6.73 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,846 |
4,289 |
$4.24 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
527 |
311 |
$0.00 |
| 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 |
6,326 |
5,348 |
$0.00 |
| 81000 |
|
1,075 |
833 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
8,925 |
6,737 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,183 |
2,282 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,589 |
1,147 |
$0.00 |
| 81001 |
|
357 |
211 |
$0.00 |
| 93000 |
|
18 |
12 |
$0.00 |
| 00000 |
|
227 |
205 |
$0.00 |
| D0603 |
|
397 |
271 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
898 |
554 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,217 |
273 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,330 |
768 |
$0.00 |
| 99443 |
|
327 |
82 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
107 |
58 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
168 |
66 |
$0.00 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
218 |
127 |
$0.00 |
| 92551 |
|
337 |
249 |
$0.00 |
| 99000 |
|
18 |
13 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
43 |
32 |
$0.00 |
| 86403 |
|
84 |
58 |
$0.00 |
| 99441 |
|
45 |
23 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
28 |
12 |
$0.00 |
| 86580 |
|
15 |
12 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
22 |
12 |
$0.00 |
| 99304 |
|
63 |
60 |
$0.00 |
| 99442 |
|
1,985 |
561 |
$0.00 |
| 81002 |
|
350 |
254 |
$0.00 |
| 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 |
783 |
649 |
$0.00 |
| 99307 |
|
5,017 |
4,422 |
$0.00 |
| 80061 |
Lipid panel |
2,849 |
2,076 |
$0.00 |
| 82947 |
|
178 |
139 |
$0.00 |
| 80305 |
|
852 |
607 |
$0.00 |
| 99173 |
|
793 |
655 |
$0.00 |
| 84702 |
|
107 |
84 |
$0.00 |
| 90756 |
|
277 |
229 |
$0.00 |
| 90715 |
|
76 |
56 |
$0.00 |
| 99382 |
|
196 |
144 |
$0.00 |
| 81025 |
|
159 |
115 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
983 |
420 |
$0.00 |
| 82274 |
|
32 |
27 |
$0.00 |
| 99401 |
|
102 |
67 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
866 |
645 |
$0.00 |
| 71046 |
Radiologic examination, chest; 2 views |
27 |
26 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
165 |
90 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
309 |
107 |
$0.00 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
107 |
58 |
$0.00 |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
25 |
13 |
$0.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
112 |
56 |
$0.00 |
| 11721 |
|
15 |
13 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$0.00 |
| 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 |
23 |
23 |
$0.00 |