| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
31,237 |
23,164 |
$1.96M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,667 |
10,774 |
$384K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,118 |
3,748 |
$178K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,468 |
724 |
$88K |
| D1110 |
Prophylaxis - adult |
4,401 |
3,357 |
$82K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,148 |
2,493 |
$71K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,145 |
2,395 |
$42K |
| D0274 |
Bitewings - four radiographic images |
3,267 |
2,605 |
$39K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,384 |
1,953 |
$38K |
| D1120 |
Prophylaxis - child |
2,544 |
2,001 |
$29K |
| D0120 |
Periodic oral evaluation - established patient |
2,784 |
2,030 |
$25K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
754 |
400 |
$23K |
| D0330 |
Panoramic radiographic image |
887 |
729 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
548 |
321 |
$18K |
| D1206 |
Topical application of fluoride varnish |
1,581 |
1,353 |
$17K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
446 |
354 |
$16K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
306 |
193 |
$14K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,738 |
1,246 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
287 |
170 |
$8K |
| D7140 |
Extraction, erupted tooth or exposed root |
319 |
159 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
167 |
110 |
$6K |
| 92551 |
|
1,752 |
1,095 |
$5K |
| 96127 |
|
2,162 |
1,115 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
120 |
65 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
128 |
71 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
642 |
427 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
86 |
49 |
$4K |
| 82962 |
|
3,344 |
2,007 |
$4K |
| 0012A |
|
94 |
92 |
$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 |
286 |
262 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,020 |
585 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
66 |
37 |
$2K |
| 0011A |
|
102 |
97 |
$2K |
| 99173 |
|
1,597 |
1,002 |
$2K |
| D0272 |
Bitewings - two radiographic images |
187 |
149 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
601 |
424 |
$987.96 |
| 81003 |
|
852 |
484 |
$984.16 |
| 81002 |
|
433 |
278 |
$685.45 |
| 81025 |
|
163 |
109 |
$672.98 |
| 0013A |
|
14 |
13 |
$479.80 |
| 11721 |
|
17 |
14 |
$425.72 |
| 99406 |
|
118 |
53 |
$362.10 |
| 90686 |
|
625 |
415 |
$220.47 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
12 |
$178.12 |
| 91301 |
|
338 |
304 |
$102.57 |
| 90656 |
|
38 |
36 |
$23.47 |
| 90670 |
|
179 |
141 |
$15.84 |
| 90633 |
|
20 |
14 |
$0.11 |
| 90698 |
|
100 |
76 |
$0.05 |
| 2001F |
|
7,650 |
5,547 |
$0.00 |
| 3008F |
|
15,285 |
9,740 |
$0.00 |
| 3074F |
|
9,742 |
6,728 |
$0.00 |
| 3080F |
|
1,336 |
894 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,675 |
1,285 |
$0.00 |
| 1036F |
|
6,881 |
4,550 |
$0.00 |
| 3079F |
|
3,748 |
2,635 |
$0.00 |
| 3075F |
|
1,476 |
1,065 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
2,879 |
2,012 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
453 |
342 |
$0.00 |
| D1330 |
|
25 |
15 |
$0.00 |
| 90744 |
|
16 |
15 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 3078F |
|
8,761 |
6,032 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
2,532 |
1,772 |
$0.00 |
| 3077F |
|
2,702 |
1,837 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
707 |
523 |
$0.00 |
| 90671 |
|
24 |
12 |
$0.00 |
| 90685 |
|
49 |
31 |
$0.00 |