| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
6,053 |
5,107 |
$560K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,470 |
6,644 |
$433K |
| T1015 |
Clinic visit/encounter, all-inclusive |
5,843 |
4,139 |
$85K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,458 |
2,060 |
$83K |
| 99215 |
Prolong outpt/office vis |
839 |
665 |
$77K |
| D1110 |
Prophylaxis - adult |
1,385 |
1,322 |
$47K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,321 |
767 |
$41K |
| 90837 |
Psychotherapy, 53 minutes with patient |
508 |
402 |
$34K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,873 |
1,773 |
$34K |
| D0274 |
Bitewings - four radiographic images |
1,834 |
1,740 |
$31K |
| D0120 |
Periodic oral evaluation - established patient |
2,268 |
2,157 |
$27K |
| D0210 |
Intraoral - complete series of radiographic images |
514 |
475 |
$18K |
| D0140 |
Limited oral evaluation - problem focused |
590 |
555 |
$16K |
| D0330 |
Panoramic radiographic image |
1,080 |
1,022 |
$14K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,576 |
1,507 |
$13K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
158 |
138 |
$13K |
| D1120 |
Prophylaxis - child |
1,378 |
1,328 |
$11K |
| 99406 |
|
1,285 |
931 |
$10K |
| 96158 |
|
1,043 |
723 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
734 |
655 |
$6K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
2,916 |
2,309 |
$5K |
| 99408 |
|
868 |
688 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
1,881 |
1,580 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
108 |
87 |
$3K |
| 99401 |
|
1,484 |
1,199 |
$3K |
| 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 |
94 |
82 |
$2K |
| 97802 |
|
187 |
157 |
$2K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
87 |
40 |
$1K |
| 90688 |
|
73 |
58 |
$1K |
| 80305 |
|
81 |
67 |
$714.97 |
| 90756 |
|
31 |
31 |
$587.53 |
| D0272 |
Bitewings - two radiographic images |
120 |
120 |
$566.42 |
| D0230 |
Intraoral - periapical each additional radiographic image |
68 |
40 |
$556.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
631 |
536 |
$538.83 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
65 |
57 |
$406.31 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
28 |
25 |
$354.81 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
110 |
84 |
$310.80 |
| 96156 |
|
70 |
45 |
$204.00 |
| 99000 |
|
22 |
20 |
$54.29 |
| 96160 |
|
45 |
40 |
$32.76 |
| D9999 |
Unspecified adjunctive procedure, by report |
698 |
487 |
$0.10 |
| 1160F |
|
2,060 |
1,598 |
$0.00 |
| 3028F |
|
2,224 |
1,772 |
$0.00 |
| 3078F |
|
733 |
603 |
$0.00 |
| 1159F |
|
2,185 |
1,721 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
111 |
103 |
$0.00 |
| 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 |
17 |
17 |
$0.00 |
| 3077F |
|
266 |
210 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
20 |
12 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
239 |
178 |
$0.00 |
| 3079F |
|
563 |
446 |
$0.00 |
| 3074F |
|
1,183 |
947 |
$0.00 |
| 1125F |
|
852 |
660 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
1,732 |
1,314 |
$0.00 |
| 3008F |
|
2,305 |
1,818 |
$0.00 |
| 0513F |
|
69 |
58 |
$0.00 |
| 1126F |
|
811 |
651 |
$0.00 |
| D5899 |
|
63 |
49 |
$0.00 |
| G9906 |
Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) |
324 |
234 |
$0.00 |
| D0INT |
|
44 |
26 |
$0.00 |
| 3075F |
|
72 |
54 |
$0.00 |
| 3080F |
|
116 |
93 |
$0.00 |