| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
84,895 |
61,726 |
$6.93M |
| 90834 |
Psychotherapy, 45 minutes with patient |
29,798 |
12,577 |
$813K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
36,659 |
20,876 |
$738K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
19,219 |
10,902 |
$600K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,618 |
4,821 |
$121K |
| D0330 |
Panoramic radiographic image |
5,553 |
3,540 |
$121K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
6,876 |
4,297 |
$102K |
| D7140 |
Extraction, erupted tooth or exposed root |
3,035 |
1,200 |
$98K |
| 90791 |
Psychiatric diagnostic evaluation |
2,166 |
1,199 |
$96K |
| D1110 |
Prophylaxis - adult |
4,140 |
2,637 |
$86K |
| D0140 |
Limited oral evaluation - problem focused |
6,803 |
4,072 |
$78K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
6,353 |
2,309 |
$67K |
| D0120 |
Periodic oral evaluation - established patient |
4,644 |
2,886 |
$53K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,173 |
1,106 |
$46K |
| D1120 |
Prophylaxis - child |
3,304 |
1,895 |
$39K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,938 |
2,357 |
$39K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,179 |
1,352 |
$37K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
934 |
553 |
$36K |
| D0274 |
Bitewings - four radiographic images |
4,095 |
2,721 |
$35K |
| 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 |
2,504 |
2,214 |
$35K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
741 |
386 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,042 |
1,489 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,475 |
2,462 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,274 |
879 |
$19K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
684 |
383 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
376 |
235 |
$15K |
| 92015 |
Determination of refractive state |
4,586 |
3,431 |
$14K |
| 99215 |
Prolong outpt/office vis |
336 |
175 |
$14K |
| 90785 |
|
2,395 |
921 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
326 |
195 |
$10K |
| Q3014 |
Telehealth originating site facility fee |
951 |
562 |
$10K |
| D0210 |
Intraoral - complete series of radiographic images |
249 |
175 |
$10K |
| D0220 |
Intraoral - periapical first radiographic image |
2,864 |
1,736 |
$7K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
253 |
143 |
$6K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
478 |
304 |
$6K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
229 |
116 |
$6K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
213 |
116 |
$6K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
127 |
76 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
496 |
269 |
$3K |
| 90686 |
|
579 |
377 |
$3K |
| D0272 |
Bitewings - two radiographic images |
557 |
313 |
$3K |
| 90837 |
Psychotherapy, 53 minutes with patient |
71 |
36 |
$3K |
| 99383 |
|
53 |
26 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
46 |
38 |
$2K |
| 99385 |
|
50 |
26 |
$2K |
| 92341 |
|
301 |
222 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
38 |
28 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
215 |
137 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
272 |
175 |
$946.68 |
| 99386 |
|
21 |
12 |
$906.80 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
29 |
14 |
$873.80 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
128 |
88 |
$484.46 |
| 92250 |
|
13 |
12 |
$428.69 |
| V2020 |
Frames, purchases |
252 |
252 |
$388.00 |
| 92551 |
|
115 |
70 |
$354.60 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
98 |
65 |
$320.54 |
| 90651 |
|
218 |
202 |
$286.78 |
| 99173 |
|
186 |
111 |
$222.56 |
| D0230 |
Intraoral - periapical each additional radiographic image |
40 |
13 |
$146.25 |
| 90656 |
|
99 |
94 |
$96.25 |
| 82962 |
|
75 |
42 |
$95.66 |
| 81002 |
|
128 |
83 |
$82.69 |
| 81025 |
|
34 |
25 |
$52.00 |
| 3077F |
|
530 |
511 |
$0.00 |
| 1159F |
|
3,565 |
3,354 |
$0.00 |
| 3078F |
|
1,867 |
1,773 |
$0.00 |
| 3725F |
|
1,564 |
1,249 |
$0.00 |
| 2028F |
|
14 |
12 |
$0.00 |
| 4004F |
|
102 |
97 |
$0.00 |
| 90633 |
|
26 |
25 |
$0.00 |
| 90710 |
|
13 |
12 |
$0.00 |
| 90715 |
|
26 |
24 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
23 |
18 |
$0.00 |
| 3074F |
|
2,111 |
2,008 |
$0.00 |
| D0603 |
|
880 |
870 |
$0.00 |
| 1034F |
|
2,090 |
1,544 |
$0.00 |
| 1000F |
|
3,867 |
2,886 |
$0.00 |
| 3008F |
|
4,323 |
3,236 |
$0.00 |
| 1036F |
|
1,639 |
1,231 |
$0.00 |
| 4000F |
|
178 |
132 |
$0.00 |
| 3079F |
|
749 |
727 |
$0.00 |
| 3075F |
|
268 |
258 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 90619 |
|
121 |
112 |
$0.00 |
| 1035F |
|
66 |
48 |
$0.00 |
| D1320 |
|
183 |
183 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
132 |
78 |
$0.00 |
| 3080F |
|
295 |
286 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
24 |
12 |
$0.00 |