| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
11,278 |
9,962 |
$773K |
| D0120 |
Periodic oral evaluation - established patient |
18,669 |
14,308 |
$723K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,759 |
6,061 |
$633K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
3,124 |
2,627 |
$388K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,939 |
2,505 |
$253K |
| D0274 |
Bitewings - four radiographic images |
5,809 |
5,033 |
$214K |
| D0210 |
Intraoral - complete series of radiographic images |
3,450 |
3,312 |
$181K |
| 36415 |
Collection of venous blood by venipuncture |
9,870 |
2,279 |
$163K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
1,019 |
868 |
$146K |
| D0140 |
Limited oral evaluation - problem focused |
5,693 |
4,687 |
$129K |
| D0220 |
Intraoral - periapical first radiographic image |
6,285 |
5,492 |
$129K |
| D1120 |
Prophylaxis - child |
2,287 |
2,179 |
$124K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,325 |
1,070 |
$111K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,382 |
2,510 |
$111K |
| D5110 |
|
340 |
189 |
$98K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,879 |
3,754 |
$74K |
| 99442 |
|
1,585 |
1,498 |
$70K |
| 80053 |
Comprehensive metabolic panel |
1,981 |
1,728 |
$69K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
353 |
338 |
$64K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
752 |
704 |
$59K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
798 |
796 |
$56K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
779 |
668 |
$54K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
740 |
737 |
$52K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
228 |
64 |
$36K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
1,793 |
1,276 |
$30K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,024 |
809 |
$21K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
692 |
657 |
$15K |
| D2331 |
|
121 |
90 |
$15K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
390 |
390 |
$11K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
254 |
251 |
$11K |
| D0330 |
Panoramic radiographic image |
246 |
212 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
129 |
129 |
$10K |
| D2330 |
|
101 |
93 |
$10K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
706 |
654 |
$10K |
| 87631 |
|
54 |
52 |
$9K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
53 |
51 |
$9K |
| D2740 |
Crown - porcelain/ceramic |
15 |
12 |
$9K |
| 80061 |
Lipid panel |
805 |
801 |
$8K |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
489 |
439 |
$7K |
| 99406 |
|
749 |
733 |
$7K |
| D2394 |
|
40 |
36 |
$7K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
44 |
39 |
$6K |
| 84443 |
Thyroid stimulating hormone (TSH) |
611 |
602 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,426 |
1,311 |
$5K |
| D2335 |
|
13 |
13 |
$3K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
83 |
79 |
$3K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
27 |
25 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
314 |
313 |
$3K |
| D0272 |
Bitewings - two radiographic images |
100 |
84 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
34 |
13 |
$2K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
15 |
14 |
$1K |
| 81003 |
|
183 |
77 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
33 |
25 |
$1K |
| D7140 |
Extraction, erupted tooth or exposed root |
13 |
13 |
$767.78 |
| 20610 |
|
12 |
12 |
$614.40 |
| 99441 |
|
24 |
23 |
$259.30 |
| 88304 |
|
12 |
12 |
$224.64 |
| 51798 |
|
15 |
12 |
$190.23 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$148.78 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
28 |
27 |
$84.14 |
| 85027 |
|
12 |
12 |
$47.83 |
| 83690 |
|
13 |
12 |
$21.80 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
109 |
103 |
$0.00 |