| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
101,692 |
74,821 |
$23.23M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,029 |
7,385 |
$226K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,957 |
1,744 |
$173K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,710 |
3,837 |
$147K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,973 |
2,295 |
$113K |
| H0022 |
Alcohol and/or drug intervention service (planned facilitation) |
2,240 |
1,237 |
$84K |
| D7140 |
Extraction, erupted tooth or exposed root |
11,725 |
5,095 |
$49K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
11,038 |
7,196 |
$48K |
| 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 |
2,710 |
1,728 |
$45K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
6,213 |
4,001 |
$19K |
| 80305 |
|
2,099 |
1,182 |
$18K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
10,774 |
9,669 |
$16K |
| D0210 |
Intraoral - complete series of radiographic images |
6,050 |
5,379 |
$16K |
| D1110 |
Prophylaxis - adult |
10,873 |
9,828 |
$15K |
| D0140 |
Limited oral evaluation - problem focused |
14,331 |
12,947 |
$14K |
| D1206 |
Topical application of fluoride varnish |
21,920 |
20,022 |
$14K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
2,213 |
1,659 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
718 |
645 |
$11K |
| D1351 |
Sealant - per tooth |
7,176 |
1,586 |
$8K |
| 99215 |
Prolong outpt/office vis |
220 |
142 |
$6K |
| D0274 |
Bitewings - four radiographic images |
7,944 |
7,198 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
11,784 |
10,741 |
$6K |
| D1120 |
Prophylaxis - child |
8,285 |
7,660 |
$6K |
| 90686 |
|
560 |
505 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
12,450 |
11,214 |
$5K |
| 0002A |
|
150 |
146 |
$5K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
101 |
91 |
$5K |
| 90791 |
Psychiatric diagnostic evaluation |
145 |
99 |
$5K |
| 0001A |
|
140 |
133 |
$5K |
| 87428 |
|
156 |
135 |
$3K |
| 0031A |
|
80 |
77 |
$3K |
| 3008F |
|
330 |
307 |
$2K |
| 80061 |
Lipid panel |
213 |
203 |
$2K |
| D4355 |
|
61 |
58 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
211 |
197 |
$2K |
| D0191 |
|
1,539 |
1,438 |
$2K |
| 80053 |
Comprehensive metabolic panel |
178 |
167 |
$1K |
| 0012A |
|
33 |
32 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
24 |
$1K |
| 0071A |
|
42 |
27 |
$1K |
| D0330 |
Panoramic radiographic image |
220 |
189 |
$1K |
| D2394 |
|
48 |
42 |
$964.90 |
| D0272 |
Bitewings - two radiographic images |
2,368 |
2,165 |
$952.65 |
| 0011A |
|
33 |
33 |
$852.00 |
| 0004A |
|
22 |
20 |
$725.04 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$670.78 |
| 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 |
42 |
25 |
$668.79 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
12 |
$645.15 |
| 0072A |
|
23 |
12 |
$577.92 |
| 0054A |
|
12 |
12 |
$457.92 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
22 |
12 |
$405.02 |
| 90656 |
|
17 |
17 |
$323.28 |
| 36415 |
Collection of venous blood by venipuncture |
1,871 |
1,641 |
$284.17 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
12 |
$177.62 |
| D0270 |
|
782 |
690 |
$174.15 |
| 81003 |
|
110 |
102 |
$164.58 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
18 |
15 |
$138.67 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
49 |
37 |
$136.07 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,116 |
1,026 |
$74.17 |
| 99000 |
|
13 |
13 |
$50.96 |
| 85018 |
|
32 |
26 |
$47.30 |
| 36416 |
|
13 |
13 |
$15.15 |
| 91300 |
|
386 |
347 |
$0.26 |
| 91301 |
|
72 |
71 |
$0.05 |
| 3075F |
|
338 |
310 |
$0.00 |
| D2160 |
|
69 |
65 |
$0.00 |
| D5899 |
|
2,716 |
1,354 |
$0.00 |
| 3079F |
|
1,104 |
986 |
$0.00 |
| 3074F |
|
4,521 |
3,946 |
$0.00 |
| D2331 |
|
496 |
369 |
$0.00 |
| D0603 |
|
358 |
340 |
$0.00 |
| D2335 |
|
58 |
50 |
$0.00 |
| 91307 |
|
71 |
40 |
$0.00 |
| D2330 |
|
52 |
40 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
212 |
157 |
$0.00 |
| D0601 |
|
13 |
13 |
$0.00 |
| D0602 |
|
70 |
70 |
$0.00 |
| 91305 |
|
14 |
14 |
$0.00 |
| 91303 |
|
83 |
77 |
$0.00 |
| 3078F |
|
3,938 |
3,458 |
$0.00 |
| D2140 |
|
149 |
123 |
$0.00 |
| 3077F |
|
145 |
134 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
980 |
720 |
$0.00 |
| D2332 |
|
32 |
27 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
19 |
12 |
$0.00 |
| D1354 |
|
325 |
91 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
15 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
15 |
14 |
$0.00 |
| D2951 |
|
17 |
16 |
$0.00 |
| D2940 |
|
13 |
12 |
$0.00 |