| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
23,976 |
19,210 |
$1.55M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,398 |
10,647 |
$361K |
| D7140 |
Extraction, erupted tooth or exposed root |
4,373 |
1,862 |
$127K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,296 |
2,108 |
$104K |
| D0330 |
Panoramic radiographic image |
3,368 |
2,197 |
$80K |
| D1110 |
Prophylaxis - adult |
4,218 |
2,810 |
$53K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,915 |
1,022 |
$48K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,029 |
1,985 |
$41K |
| D0140 |
Limited oral evaluation - problem focused |
3,958 |
2,712 |
$35K |
| D1206 |
Topical application of fluoride varnish |
3,829 |
2,376 |
$25K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,221 |
755 |
$22K |
| 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 |
781 |
689 |
$22K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,098 |
559 |
$20K |
| D1120 |
Prophylaxis - child |
2,501 |
1,635 |
$20K |
| D0120 |
Periodic oral evaluation - established patient |
3,704 |
2,331 |
$18K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
293 |
195 |
$13K |
| D0274 |
Bitewings - four radiographic images |
2,161 |
1,455 |
$13K |
| D0220 |
Intraoral - periapical first radiographic image |
4,061 |
2,832 |
$10K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,586 |
687 |
$6K |
| 99406 |
|
977 |
532 |
$4K |
| 99441 |
|
495 |
237 |
$3K |
| D2330 |
|
81 |
44 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
247 |
159 |
$2K |
| D2331 |
|
37 |
25 |
$1K |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
236 |
101 |
$1K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
14 |
14 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
336 |
218 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
105 |
55 |
$855.94 |
| 90686 |
|
126 |
75 |
$847.07 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
29 |
17 |
$759.55 |
| D0272 |
Bitewings - two radiographic images |
543 |
374 |
$680.50 |
| 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 |
88 |
84 |
$506.73 |
| 36416 |
|
680 |
464 |
$456.06 |
| D0210 |
Intraoral - complete series of radiographic images |
34 |
34 |
$347.14 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
173 |
137 |
$330.55 |
| 81025 |
|
109 |
72 |
$290.16 |
| 90756 |
|
23 |
13 |
$227.90 |
| 81002 |
|
107 |
69 |
$100.20 |
| 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 |
20 |
19 |
$64.66 |
| D0270 |
|
14 |
14 |
$62.74 |
| 3077F |
|
3,044 |
1,614 |
$0.08 |
| 3079F |
|
5,972 |
3,271 |
$0.04 |
| 3078F |
|
7,665 |
4,017 |
$0.02 |
| 3075F |
|
3,764 |
2,062 |
$0.02 |
| 3074F |
|
8,457 |
4,413 |
$0.02 |
| D1999 |
|
1,756 |
1,202 |
$0.00 |
| 1159F |
|
365 |
346 |
$0.00 |
| 98960 |
|
47 |
21 |
$0.00 |
| 1160F |
|
365 |
346 |
$0.00 |
| 90863 |
|
15 |
15 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
339 |
219 |
$0.00 |
| D2394 |
|
14 |
12 |
$0.00 |
| 3080F |
|
1,630 |
838 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
290 |
268 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
197 |
127 |
$0.00 |
| 1111F |
|
2,128 |
1,247 |
$0.00 |
| 1036F |
|
3,577 |
1,862 |
$0.00 |
| 0001F |
|
423 |
260 |
$0.00 |
| D0603 |
|
336 |
214 |
$0.00 |
| 1000F |
|
144 |
94 |
$0.00 |
| 87110 |
|
19 |
12 |
$0.00 |
| D2335 |
|
15 |
12 |
$0.00 |