| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
66,410 |
47,985 |
$4.05M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
52,064 |
29,425 |
$1.11M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,017 |
9,158 |
$476K |
| 90834 |
Psychotherapy, 45 minutes with patient |
6,157 |
2,314 |
$184K |
| D1110 |
Prophylaxis - adult |
7,406 |
4,459 |
$95K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,133 |
3,387 |
$83K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,570 |
2,823 |
$53K |
| D1206 |
Topical application of fluoride varnish |
6,468 |
3,836 |
$48K |
| D1120 |
Prophylaxis - child |
4,371 |
2,648 |
$39K |
| D0274 |
Bitewings - four radiographic images |
5,036 |
3,140 |
$30K |
| D7140 |
Extraction, erupted tooth or exposed root |
932 |
425 |
$29K |
| D0120 |
Periodic oral evaluation - established patient |
4,631 |
3,034 |
$27K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
634 |
361 |
$24K |
| D0330 |
Panoramic radiographic image |
1,255 |
805 |
$17K |
| D0140 |
Limited oral evaluation - problem focused |
2,661 |
1,820 |
$16K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,374 |
918 |
$13K |
| 36415 |
Collection of venous blood by venipuncture |
10,479 |
6,227 |
$12K |
| 99215 |
Prolong outpt/office vis |
282 |
221 |
$12K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
501 |
256 |
$12K |
| 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 |
776 |
680 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
239 |
149 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
300 |
184 |
$8K |
| 90791 |
Psychiatric diagnostic evaluation |
159 |
80 |
$7K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
239 |
164 |
$6K |
| 0011A |
|
192 |
185 |
$6K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
142 |
82 |
$6K |
| 81003 |
|
6,093 |
3,279 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
613 |
422 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
2,997 |
2,002 |
$5K |
| 0012A |
|
146 |
143 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
182 |
101 |
$5K |
| 81025 |
|
1,096 |
660 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
82 |
55 |
$3K |
| 90686 |
|
517 |
379 |
$3K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
428 |
262 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
300 |
188 |
$2K |
| 0064A |
|
64 |
61 |
$2K |
| 92551 |
|
665 |
407 |
$2K |
| D1351 |
Sealant - per tooth |
202 |
39 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
237 |
156 |
$2K |
| 90756 |
|
111 |
71 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
445 |
278 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$825.69 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
192 |
155 |
$823.47 |
| D0272 |
Bitewings - two radiographic images |
195 |
108 |
$793.56 |
| 99173 |
|
645 |
394 |
$774.00 |
| 0031A |
|
21 |
20 |
$740.62 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
110 |
61 |
$703.64 |
| 85018 |
|
537 |
358 |
$562.20 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
43 |
31 |
$561.58 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
91 |
46 |
$529.58 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
19 |
12 |
$94.50 |
| 1111F |
|
2,556 |
2,211 |
$75.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
260 |
230 |
$15.75 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13 |
12 |
$5.76 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
90 |
46 |
$5.05 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
1,772 |
1,597 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
13,923 |
12,531 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
5,082 |
4,716 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
424 |
380 |
$0.00 |
| 3078F |
|
5,836 |
5,133 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
97 |
97 |
$0.00 |
| 3050F |
|
44 |
42 |
$0.00 |
| 3077F |
|
316 |
274 |
$0.00 |
| 90461 |
|
20 |
18 |
$0.00 |
| 3008F |
|
18,542 |
16,620 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
7,173 |
6,687 |
$0.00 |
| 2001F |
|
18,531 |
16,585 |
$0.00 |
| 3079F |
|
4,171 |
3,713 |
$0.00 |
| 3075F |
|
721 |
659 |
$0.00 |
| 3074F |
|
8,477 |
7,434 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
14,528 |
13,074 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
403 |
375 |
$0.00 |
| 91301 |
|
26 |
25 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
122 |
108 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
69 |
57 |
$0.00 |
| 3048F |
|
142 |
142 |
$0.00 |
| 3080F |
|
18 |
16 |
$0.00 |
| 3049F |
|
15 |
15 |
$0.00 |