| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
56,588 |
45,420 |
$13.83M |
| 90832 |
Psychotherapy, 30 minutes with patient |
10,048 |
5,834 |
$203K |
| 90834 |
Psychotherapy, 45 minutes with patient |
7,027 |
3,733 |
$175K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,734 |
5,514 |
$133K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,185 |
2,655 |
$112K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
5,705 |
4,351 |
$33K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,426 |
1,212 |
$24K |
| D0210 |
Intraoral - complete series of radiographic images |
4,111 |
3,936 |
$23K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
3,715 |
2,845 |
$20K |
| 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 |
890 |
731 |
$20K |
| D1206 |
Topical application of fluoride varnish |
17,056 |
16,378 |
$19K |
| D1110 |
Prophylaxis - adult |
8,791 |
8,470 |
$18K |
| D1120 |
Prophylaxis - child |
7,111 |
6,827 |
$15K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,172 |
4,007 |
$14K |
| D0120 |
Periodic oral evaluation - established patient |
10,405 |
10,021 |
$12K |
| D0274 |
Bitewings - four radiographic images |
6,713 |
6,481 |
$11K |
| D1351 |
Sealant - per tooth |
6,354 |
1,739 |
$10K |
| D0140 |
Limited oral evaluation - problem focused |
7,898 |
7,465 |
$9K |
| 99000 |
|
3,033 |
2,535 |
$8K |
| D0191 |
|
6,384 |
6,166 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
15,448 |
14,628 |
$6K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
634 |
563 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
17,963 |
9,565 |
$4K |
| 98940 |
|
4,626 |
2,203 |
$3K |
| 91322 |
|
56 |
39 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
158 |
137 |
$2K |
| 90688 |
|
226 |
204 |
$2K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
38 |
36 |
$2K |
| D0272 |
Bitewings - two radiographic images |
1,601 |
1,517 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
46 |
42 |
$2K |
| D0330 |
Panoramic radiographic image |
484 |
452 |
$1K |
| 90686 |
|
121 |
116 |
$1K |
| 90837 |
Psychotherapy, 53 minutes with patient |
15 |
12 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
20 |
17 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
2,738 |
2,345 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
18 |
17 |
$934.80 |
| 90480 |
|
36 |
27 |
$610.56 |
| 99442 |
|
24 |
14 |
$252.72 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13 |
13 |
$211.98 |
| 3008F |
|
135 |
123 |
$70.00 |
| 90715 |
|
16 |
16 |
$52.96 |
| 96160 |
|
13 |
12 |
$44.60 |
| D4355 |
|
481 |
470 |
$0.00 |
| D5899 |
|
248 |
161 |
$0.00 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
78 |
44 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
255 |
224 |
$0.00 |
| D2331 |
|
30 |
26 |
$0.00 |
| 3074F |
|
107 |
100 |
$0.00 |
| D2330 |
|
40 |
26 |
$0.00 |
| 3079F |
|
20 |
18 |
$0.00 |
| D0240 |
|
154 |
73 |
$0.00 |
| D0270 |
|
1,578 |
1,458 |
$0.00 |
| D1354 |
|
37 |
12 |
$0.00 |
| 3078F |
|
82 |
77 |
$0.00 |
| 3077F |
|
14 |
12 |
$0.00 |