| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
107,719 |
90,573 |
$10.47M |
| T2022 |
Case management, per month |
3,536 |
3,180 |
$443K |
| D0120 |
Periodic oral evaluation - established patient |
11,958 |
11,633 |
$349K |
| D0274 |
Bitewings - four radiographic images |
6,473 |
6,283 |
$223K |
| D1110 |
Prophylaxis - adult |
3,010 |
2,903 |
$180K |
| D1208 |
Topical application of fluoride, excluding varnish |
7,532 |
7,360 |
$170K |
| D1120 |
Prophylaxis - child |
3,008 |
2,947 |
$135K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
970 |
862 |
$125K |
| D0230 |
Intraoral - periapical each additional radiographic image |
5,711 |
2,081 |
$59K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,183 |
1,146 |
$54K |
| D0330 |
Panoramic radiographic image |
1,050 |
1,014 |
$39K |
| D0220 |
Intraoral - periapical first radiographic image |
3,185 |
3,101 |
$38K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
345 |
288 |
$31K |
| D0140 |
Limited oral evaluation - problem focused |
639 |
616 |
$25K |
| D0272 |
Bitewings - two radiographic images |
431 |
429 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
51,271 |
44,302 |
$10K |
| D1351 |
Sealant - per tooth |
244 |
66 |
$9K |
| D1206 |
Topical application of fluoride varnish |
518 |
451 |
$8K |
| T2023 |
Targeted case management; per month |
74 |
64 |
$5K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
31 |
29 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,726 |
5,616 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,008 |
5,568 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,801 |
4,682 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
6,803 |
6,230 |
$1K |
| D0145 |
Oral evaluation for a patient under three years of age |
29 |
29 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,610 |
3,966 |
$320.92 |
| 97803 |
|
1,370 |
1,295 |
$126.80 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
22,278 |
21,877 |
$119.76 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
4,693 |
2,090 |
$97.67 |
| 97802 |
|
488 |
458 |
$58.82 |
| 96127 |
|
11,269 |
11,041 |
$4.42 |
| D0999 |
Unspecified diagnostic procedure, by report |
16,710 |
15,868 |
$0.02 |
| 90670 |
|
2,938 |
2,829 |
$0.00 |
| 0054A |
|
155 |
140 |
$0.00 |
| D2999 |
|
7,190 |
6,232 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
9,857 |
9,702 |
$0.00 |
| 99173 |
|
5,428 |
5,335 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
810 |
778 |
$0.00 |
| 99442 |
|
206 |
152 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,783 |
1,707 |
$0.00 |
| 99177 |
|
1,650 |
1,615 |
$0.00 |
| 0002A |
|
345 |
335 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,046 |
791 |
$0.00 |
| H0036 |
Community psychiatric supportive treatment, face-to-face, per 15 minutes |
85 |
37 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
357 |
349 |
$0.00 |
| 90461 |
|
788 |
767 |
$0.00 |
| 81025 |
|
887 |
857 |
$0.00 |
| 91300 |
|
953 |
843 |
$0.00 |
| 99188 |
|
916 |
895 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
803 |
779 |
$0.00 |
| 90715 |
|
334 |
320 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
347 |
223 |
$0.00 |
| 90685 |
|
289 |
289 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,872 |
1,723 |
$0.00 |
| 90671 |
|
466 |
465 |
$0.00 |
| 90633 |
|
944 |
917 |
$0.00 |
| 90672 |
|
226 |
216 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
820 |
782 |
$0.00 |
| 91320 |
|
69 |
69 |
$0.00 |
| 90734 |
|
63 |
63 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
26 |
26 |
$0.00 |
| 90707 |
|
100 |
99 |
$0.00 |
| 91312 |
|
55 |
55 |
$0.00 |
| 90710 |
|
91 |
91 |
$0.00 |
| D0191 |
|
336 |
319 |
$0.00 |
| 90662 |
|
124 |
88 |
$0.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
55 |
49 |
$0.00 |
| 90473 |
|
141 |
141 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
216 |
102 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
12 |
$0.00 |
| 0004A |
|
112 |
95 |
$0.00 |
| 0124A |
|
86 |
84 |
$0.00 |
| 0071A |
|
43 |
43 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
19 |
15 |
$0.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
32 |
32 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
21 |
16 |
$0.00 |
| 90686 |
|
10,073 |
9,722 |
$0.00 |
| 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 |
5,424 |
2,861 |
$0.00 |
| 92551 |
|
6,007 |
5,908 |
$0.00 |
| 90680 |
|
1,989 |
1,936 |
$0.00 |
| 90474 |
|
1,599 |
1,575 |
$0.00 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
56 |
37 |
$0.00 |
| 90647 |
|
1,182 |
1,145 |
$0.00 |
| 90651 |
|
469 |
453 |
$0.00 |
| D9995 |
|
30 |
29 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,499 |
856 |
$0.00 |
| 90656 |
|
412 |
404 |
$0.00 |
| 99381 |
|
1,300 |
1,253 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,223 |
3,169 |
$0.00 |
| 96161 |
|
641 |
631 |
$0.00 |
| 90723 |
|
1,307 |
1,266 |
$0.00 |
| 91307 |
|
213 |
212 |
$0.00 |
| 90619 |
|
53 |
53 |
$0.00 |
| 90716 |
|
51 |
51 |
$0.00 |
| 81000 |
|
195 |
188 |
$0.00 |
| 0001A |
|
481 |
458 |
$0.00 |
| 91301 |
|
638 |
634 |
$0.00 |
| 36406 |
|
24 |
24 |
$0.00 |
| 90697 |
|
827 |
818 |
$0.00 |
| 90688 |
|
156 |
147 |
$0.00 |
| 90480 |
|
394 |
393 |
$0.00 |
| 90696 |
|
84 |
80 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
123 |
108 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
469 |
429 |
$0.00 |
| 87428 |
|
98 |
97 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
340 |
188 |
$0.00 |
| 0012A |
|
344 |
344 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
30 |
27 |
$0.00 |
| 90698 |
|
15 |
15 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
29 |
29 |
$0.00 |
| 99174 |
|
12 |
12 |
$0.00 |
| 91305 |
|
115 |
109 |
$0.00 |
| 90660 |
|
62 |
62 |
$0.00 |
| 90674 |
|
78 |
69 |
$0.00 |
| 99385 |
|
15 |
15 |
$0.00 |
| 0011A |
|
257 |
257 |
$0.00 |
| 90677 |
|
333 |
328 |
$0.00 |
| 91318 |
|
13 |
13 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
103 |
95 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
27 |
26 |
$0.00 |
| 90620 |
|
13 |
12 |
$0.00 |