| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
29,703 |
23,393 |
$4.52M |
| H2020 |
Therapeutic behavioral services, per diem |
8,692 |
4,430 |
$919K |
| D0999 |
Unspecified diagnostic procedure, by report |
4,934 |
2,095 |
$340K |
| 99051 |
|
1,532 |
1,350 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,863 |
16,918 |
$642.45 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
294 |
252 |
$480.00 |
| 90651 |
|
57 |
45 |
$224.00 |
| 3074F |
|
15,208 |
12,213 |
$200.90 |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,044 |
545 |
$195.00 |
| 99177 |
|
1,558 |
1,284 |
$123.36 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
505 |
446 |
$119.40 |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,313 |
1,249 |
$112.82 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,981 |
3,118 |
$112.77 |
| 92551 |
|
1,469 |
1,279 |
$78.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,105 |
1,203 |
$67.40 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
929 |
557 |
$65.49 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
622 |
528 |
$63.65 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,656 |
1,441 |
$29.89 |
| 3008F |
|
22,266 |
16,643 |
$9.00 |
| 85018 |
|
1,842 |
1,549 |
$8.00 |
| 3078F |
|
15,177 |
12,215 |
$5.00 |
| 1126F |
|
13,970 |
10,989 |
$2.00 |
| 1036F |
|
14,044 |
10,199 |
$1.00 |
| 3077F |
|
1,728 |
1,367 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
431 |
372 |
$0.00 |
| 90633 |
|
211 |
180 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
837 |
732 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
49 |
39 |
$0.00 |
| 1160F |
|
15,865 |
12,379 |
$0.00 |
| 1159F |
|
15,873 |
12,381 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
783 |
407 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
3,638 |
2,647 |
$0.00 |
| D1110 |
Prophylaxis - adult |
491 |
321 |
$0.00 |
| D1120 |
Prophylaxis - child |
304 |
293 |
$0.00 |
| D0330 |
Panoramic radiographic image |
969 |
544 |
$0.00 |
| 81003 |
|
262 |
201 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
286 |
260 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
281 |
208 |
$0.00 |
| 90671 |
|
167 |
145 |
$0.00 |
| 90662 |
|
27 |
25 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
1,161 |
529 |
$0.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
137 |
112 |
$0.00 |
| 90734 |
|
131 |
102 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,261 |
1,608 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
295 |
254 |
$0.00 |
| 81025 |
|
375 |
274 |
$0.00 |
| D0190 |
|
15 |
14 |
$0.00 |
| 90461 |
|
1,265 |
985 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
80 |
61 |
$0.00 |
| 90681 |
|
113 |
95 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
148 |
135 |
$0.00 |
| 96160 |
|
234 |
197 |
$0.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
104 |
69 |
$0.00 |
| 90700 |
|
16 |
13 |
$0.00 |
| 90670 |
|
77 |
70 |
$0.00 |
| 90715 |
|
13 |
12 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| D9996 |
|
15 |
14 |
$0.00 |
| 96127 |
|
18,056 |
12,183 |
$0.00 |
| 90647 |
|
495 |
428 |
$0.00 |
| 3075F |
|
3,819 |
3,152 |
$0.00 |
| 1034F |
|
5,132 |
3,663 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
10,135 |
7,951 |
$0.00 |
| 3079F |
|
4,722 |
3,831 |
$0.00 |
| 1125F |
|
5,857 |
4,915 |
$0.00 |
| 1035F |
|
1,372 |
1,025 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
190 |
159 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
181 |
179 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
329 |
325 |
$0.00 |
| D0603 |
|
486 |
215 |
$0.00 |
| D1330 |
|
673 |
303 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
951 |
748 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
440 |
353 |
$0.00 |
| 94760 |
|
137 |
129 |
$0.00 |
| 90723 |
|
424 |
364 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
616 |
221 |
$0.00 |
| 96161 |
|
1,172 |
875 |
$0.00 |
| 00000 |
|
465 |
253 |
$0.00 |
| 99000 |
|
310 |
277 |
$0.00 |
| D1351 |
Sealant - per tooth |
216 |
60 |
$0.00 |
| 90686 |
|
454 |
394 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,040 |
659 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
1,110 |
157 |
$0.00 |
| 3080F |
|
510 |
419 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
77 |
66 |
$0.00 |
| 1000F |
|
111 |
101 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
148 |
80 |
$0.00 |
| 90680 |
|
111 |
95 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
71 |
42 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
39 |
39 |
$0.00 |
| 90677 |
|
282 |
245 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
59 |
13 |
$0.00 |
| 90674 |
|
14 |
12 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
18 |
14 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
48 |
47 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
16 |
13 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
15 |
12 |
$0.00 |
| 96380 |
|
18 |
17 |
$0.00 |
| G9432 |
Asthma well-controlled based on the act, c-act, acq, or ataq score and results documented |
13 |
13 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
17 |
13 |
$0.00 |