| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
59,500 |
43,957 |
$14.05M |
| 0012A |
|
419 |
418 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,512 |
11,920 |
$2K |
| 0011A |
|
318 |
317 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18,469 |
15,122 |
$1K |
| 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 |
256 |
203 |
$208.30 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,193 |
918 |
$85.17 |
| 99000 |
|
3,066 |
2,806 |
$20.43 |
| 36415 |
Collection of venous blood by venipuncture |
2,365 |
2,134 |
$2.59 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
191 |
134 |
$2.13 |
| D0274 |
Bitewings - four radiographic images |
1,152 |
996 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,171 |
660 |
$0.00 |
| 81002 |
|
419 |
351 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
980 |
926 |
$0.00 |
| D1354 |
|
2,294 |
508 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
751 |
695 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
143 |
135 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
4,911 |
4,325 |
$0.00 |
| 3078F |
|
3,016 |
2,722 |
$0.00 |
| 81003 |
|
1,404 |
1,239 |
$0.00 |
| 3077F |
|
1,178 |
1,096 |
$0.00 |
| 81025 |
|
1,114 |
981 |
$0.00 |
| D1120 |
Prophylaxis - child |
3,582 |
3,122 |
$0.00 |
| 90715 |
|
151 |
148 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
366 |
350 |
$0.00 |
| 1159F |
|
4,400 |
3,878 |
$0.00 |
| D1110 |
Prophylaxis - adult |
954 |
790 |
$0.00 |
| 3051F |
|
98 |
94 |
$0.00 |
| 90662 |
|
173 |
165 |
$0.00 |
| 3046F |
|
195 |
175 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
533 |
490 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
268 |
216 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
945 |
883 |
$0.00 |
| 91322 |
|
84 |
84 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
39 |
36 |
$0.00 |
| 97803 |
|
619 |
527 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
190 |
163 |
$0.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
96 |
87 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
53 |
46 |
$0.00 |
| 99173 |
|
122 |
115 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
78 |
76 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$0.00 |
| 3050F |
|
30 |
29 |
$0.00 |
| 91313 |
|
92 |
79 |
$0.00 |
| 82274 |
|
29 |
29 |
$0.00 |
| D0330 |
Panoramic radiographic image |
14 |
14 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,136 |
1,037 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
5,948 |
2,964 |
$0.00 |
| 1126F |
|
2,690 |
2,471 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
4,885 |
4,293 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
975 |
614 |
$0.00 |
| 0134A |
|
244 |
219 |
$0.00 |
| D1330 |
|
1,125 |
898 |
$0.00 |
| 96156 |
|
1,768 |
1,625 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
1,504 |
1,326 |
$0.00 |
| 3074F |
|
3,247 |
2,931 |
$0.00 |
| 97802 |
|
856 |
719 |
$0.00 |
| 3075F |
|
1,361 |
1,306 |
$0.00 |
| 3008F |
|
5,917 |
5,154 |
$0.00 |
| 1111F |
|
324 |
314 |
$0.00 |
| D1310 |
|
652 |
593 |
$0.00 |
| 3052F |
|
48 |
40 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,191 |
1,912 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,136 |
971 |
$0.00 |
| D1351 |
Sealant - per tooth |
2,963 |
842 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
1,638 |
1,444 |
$0.00 |
| 1034F |
|
798 |
646 |
$0.00 |
| 3044F |
|
284 |
265 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
3,965 |
3,494 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
308 |
265 |
$0.00 |
| 3080F |
|
657 |
625 |
$0.00 |
| 87428 |
|
168 |
129 |
$0.00 |
| 3079F |
|
2,214 |
2,059 |
$0.00 |
| 90656 |
|
221 |
213 |
$0.00 |
| 92250 |
|
36 |
35 |
$0.00 |
| 90686 |
|
993 |
893 |
$0.00 |
| 1035F |
|
119 |
95 |
$0.00 |
| 91301 |
|
586 |
574 |
$0.00 |
| 0064A |
|
701 |
663 |
$0.00 |
| D0603 |
|
84 |
65 |
$0.00 |
| 36416 |
|
307 |
295 |
$0.00 |
| 1036F |
|
5,633 |
4,838 |
$0.00 |
| 2001F |
|
5,899 |
5,134 |
$0.00 |
| 1125F |
|
1,522 |
1,384 |
$0.00 |
| 0031A |
|
18 |
18 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
248 |
215 |
$0.00 |
| 90480 |
|
124 |
122 |
$0.00 |
| 3048F |
|
58 |
58 |
$0.00 |
| 91303 |
|
18 |
18 |
$0.00 |
| 92551 |
|
56 |
52 |
$0.00 |
| 96150 |
|
32 |
30 |
$0.00 |
| 90688 |
|
115 |
87 |
$0.00 |
| D7111 |
|
29 |
13 |
$0.00 |
| D0601 |
|
85 |
63 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
79 |
54 |
$0.00 |
| 90732 |
|
12 |
12 |
$0.00 |
| 88142 |
|
14 |
14 |
$0.00 |
| D0602 |
|
38 |
23 |
$0.00 |