| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
84,495 |
40,995 |
$4.44M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63,838 |
35,701 |
$1.08M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,716 |
4,580 |
$190K |
| 90832 |
Psychotherapy, 30 minutes with patient |
8,591 |
3,717 |
$118K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,243 |
4,776 |
$109K |
| D0140 |
Limited oral evaluation - problem focused |
8,469 |
5,671 |
$104K |
| 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 |
2,715 |
1,905 |
$76K |
| D0330 |
Panoramic radiographic image |
3,700 |
2,343 |
$74K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,708 |
1,251 |
$73K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,844 |
1,355 |
$60K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,771 |
1,327 |
$53K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,882 |
2,702 |
$49K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,662 |
1,226 |
$48K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,736 |
2,471 |
$46K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,296 |
942 |
$43K |
| D1110 |
Prophylaxis - adult |
2,254 |
1,525 |
$41K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,798 |
892 |
$39K |
| 80305 |
|
7,641 |
3,732 |
$34K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
5,327 |
2,708 |
$34K |
| 90791 |
Psychiatric diagnostic evaluation |
716 |
442 |
$33K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
850 |
800 |
$33K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,970 |
1,282 |
$29K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
907 |
641 |
$24K |
| D0274 |
Bitewings - four radiographic images |
3,041 |
2,005 |
$22K |
| D0220 |
Intraoral - periapical first radiographic image |
7,396 |
4,909 |
$20K |
| D0120 |
Periodic oral evaluation - established patient |
2,313 |
1,366 |
$19K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
663 |
431 |
$17K |
| 81025 |
|
4,868 |
3,425 |
$16K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
558 |
270 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,595 |
1,236 |
$16K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
2,769 |
1,853 |
$15K |
| 90715 |
|
814 |
682 |
$12K |
| 90837 |
Psychotherapy, 53 minutes with patient |
387 |
151 |
$11K |
| D1120 |
Prophylaxis - child |
1,068 |
604 |
$11K |
| 81002 |
|
8,388 |
5,112 |
$10K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
1,950 |
1,410 |
$9K |
| 99307 |
|
3,246 |
2,386 |
$8K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,069 |
597 |
$8K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
309 |
152 |
$8K |
| 90633 |
|
372 |
321 |
$7K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
390 |
149 |
$6K |
| 87210 |
|
3,257 |
2,285 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
326 |
221 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
374 |
217 |
$6K |
| 92015 |
Determination of refractive state |
666 |
469 |
$6K |
| 90670 |
|
646 |
563 |
$6K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
260 |
171 |
$4K |
| D2140 |
|
200 |
90 |
$3K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
124 |
70 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
455 |
375 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,172 |
259 |
$2K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
74 |
38 |
$2K |
| D0272 |
Bitewings - two radiographic images |
552 |
348 |
$2K |
| 99442 |
|
213 |
117 |
$2K |
| 99050 |
|
169 |
136 |
$2K |
| 99305 |
|
113 |
81 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
16 |
14 |
$1K |
| 99441 |
|
178 |
124 |
$960.40 |
| 90651 |
|
467 |
415 |
$954.50 |
| 86580 |
|
228 |
188 |
$904.99 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
130 |
92 |
$839.28 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
46 |
38 |
$783.72 |
| D0210 |
Intraoral - complete series of radiographic images |
28 |
26 |
$755.20 |
| 92551 |
|
178 |
153 |
$703.70 |
| 99201 |
|
62 |
42 |
$666.48 |
| D1351 |
Sealant - per tooth |
68 |
15 |
$550.00 |
| 99318 |
|
51 |
31 |
$412.50 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
49 |
41 |
$365.42 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
775 |
635 |
$326.27 |
| 82948 |
|
79 |
61 |
$129.85 |
| V2020 |
Frames, purchases |
13 |
13 |
$126.00 |
| 11720 |
|
20 |
12 |
$103.56 |
| 71046 |
Radiologic examination, chest; 2 views |
12 |
12 |
$87.08 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
194 |
156 |
$81.73 |
| 90688 |
|
1,226 |
1,063 |
$3.71 |
| 90734 |
|
524 |
465 |
$0.83 |
| 90620 |
|
266 |
238 |
$0.78 |
| 90686 |
|
133 |
103 |
$0.57 |
| 90685 |
|
70 |
69 |
$0.05 |
| 99188 |
|
28 |
28 |
$0.00 |
| 90461 |
|
1,516 |
1,370 |
$0.00 |
| 90648 |
|
162 |
159 |
$0.00 |
| 90710 |
|
113 |
97 |
$0.00 |
| 90681 |
|
12 |
12 |
$0.00 |
| 90723 |
|
59 |
56 |
$0.00 |
| 90698 |
|
75 |
59 |
$0.00 |
| 90696 |
|
44 |
40 |
$0.00 |
| 90744 |
|
24 |
14 |
$0.00 |
| 1111F |
|
49 |
46 |
$0.00 |