| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
92,986 |
72,843 |
$13.40M |
| 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 |
20,191 |
17,448 |
$3.18M |
| D9450 |
|
84,952 |
48,684 |
$2.69M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
8,027 |
4,787 |
$1.09M |
| D1110 |
Prophylaxis - adult |
28,060 |
19,536 |
$843K |
| 90834 |
Psychotherapy, 45 minutes with patient |
11,320 |
6,416 |
$746K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
4,261 |
4,230 |
$618K |
| D2740 |
Crown - porcelain/ceramic |
1,193 |
979 |
$604K |
| 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 |
18,305 |
14,759 |
$581K |
| D0210 |
Intraoral - complete series of radiographic images |
10,334 |
7,046 |
$393K |
| D0274 |
Bitewings - four radiographic images |
18,120 |
13,098 |
$376K |
| D0180 |
|
16,931 |
12,106 |
$364K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
7,954 |
4,803 |
$340K |
| D0140 |
Limited oral evaluation - problem focused |
12,920 |
7,465 |
$274K |
| D0120 |
Periodic oral evaluation - established patient |
19,565 |
14,057 |
$262K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
6,745 |
3,674 |
$229K |
| D7140 |
Extraction, erupted tooth or exposed root |
5,871 |
1,859 |
$227K |
| D2751 |
Crown - porcelain fused to predominantly base metal |
535 |
357 |
$203K |
| D0220 |
Intraoral - periapical first radiographic image |
21,796 |
13,909 |
$202K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,921 |
4,891 |
$180K |
| D2331 |
|
3,673 |
1,977 |
$173K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
3,539 |
2,271 |
$165K |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,537 |
3,171 |
$159K |
| D2335 |
|
2,189 |
1,125 |
$154K |
| D0230 |
Intraoral - periapical each additional radiographic image |
21,553 |
7,602 |
$154K |
| D2332 |
|
2,696 |
1,434 |
$152K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
6,263 |
4,238 |
$126K |
| D2950 |
|
955 |
803 |
$111K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
3,208 |
1,568 |
$111K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
7,540 |
6,012 |
$108K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,481 |
3,386 |
$98K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,398 |
7,717 |
$95K |
| 90791 |
Psychiatric diagnostic evaluation |
802 |
786 |
$94K |
| 90677 |
|
345 |
344 |
$92K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,977 |
8,780 |
$91K |
| D2330 |
|
2,239 |
1,031 |
$85K |
| D4342 |
|
1,981 |
609 |
$85K |
| D1120 |
Prophylaxis - child |
1,741 |
1,715 |
$85K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
994 |
421 |
$83K |
| D0330 |
Panoramic radiographic image |
2,288 |
1,573 |
$82K |
| D2160 |
|
1,909 |
923 |
$77K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,406 |
1,383 |
$69K |
| D4341 |
|
1,633 |
514 |
$66K |
| 90686 |
|
3,543 |
3,536 |
$62K |
| 90715 |
|
1,734 |
1,731 |
$56K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,897 |
1,879 |
$53K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,682 |
1,600 |
$48K |
| 92015 |
Determination of refractive state |
3,860 |
3,855 |
$46K |
| D9110 |
|
1,923 |
1,241 |
$44K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
293 |
293 |
$43K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,802 |
5,739 |
$36K |
| 97803 |
|
857 |
722 |
$35K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,305 |
4,287 |
$35K |
| 90732 |
|
416 |
416 |
$34K |
| 93000 |
|
2,091 |
2,073 |
$31K |
| D2140 |
|
899 |
463 |
$29K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
838 |
457 |
$25K |
| D1351 |
Sealant - per tooth |
606 |
177 |
$23K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
289 |
285 |
$22K |
| D2394 |
|
422 |
224 |
$21K |
| 0001A |
|
456 |
456 |
$21K |
| 90651 |
|
85 |
85 |
$19K |
| D5211 |
|
96 |
43 |
$19K |
| 81025 |
|
2,667 |
2,559 |
$18K |
| 0002A |
|
380 |
380 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
79 |
79 |
$14K |
| 0012A |
|
281 |
281 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,570 |
1,506 |
$12K |
| 0011A |
|
313 |
313 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,121 |
1,070 |
$12K |
| D0270 |
|
1,620 |
1,144 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
780 |
773 |
$10K |
| 92341 |
|
274 |
272 |
$10K |
| D2161 |
|
187 |
99 |
$9K |
| 97802 |
|
69 |
69 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,048 |
1,042 |
$7K |
| 92552 |
|
389 |
388 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
95 |
95 |
$6K |
| 81003 |
|
3,062 |
2,941 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
767 |
396 |
$6K |
| D5212 |
|
25 |
13 |
$5K |
| 0031A |
|
101 |
101 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
94 |
65 |
$4K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
71 |
71 |
$4K |
| 99050 |
|
67 |
66 |
$3K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
274 |
258 |
$3K |
| 0134A |
|
66 |
66 |
$3K |
| D0272 |
Bitewings - two radiographic images |
166 |
144 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
72 |
71 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
78 |
78 |
$671.37 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
111 |
88 |
$485.13 |
| 82947 |
|
110 |
106 |
$400.95 |
| 81002 |
|
119 |
115 |
$300.94 |
| 82948 |
|
60 |
58 |
$115.90 |
| 99442 |
|
36 |
36 |
$104.05 |
| 0064A |
|
160 |
160 |
$91.74 |
| 96160 |
|
2,646 |
2,631 |
$46.66 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
95 |
93 |
$1.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
33 |
31 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
576 |
571 |
$0.00 |
| 91301 |
|
43 |
43 |
$0.00 |
| 91306 |
|
156 |
156 |
$0.00 |
| 99439 |
|
13 |
13 |
$0.00 |
| 99406 |
|
19 |
18 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
220 |
202 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
726 |
721 |
$0.00 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
12 |
12 |
$0.00 |
| 91313 |
|
31 |
31 |
$0.00 |