| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 41899 |
Unlisted procedure, dentoalveolar structures |
17,267 |
15,549 |
$54.24M |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
8,697 |
2,963 |
$1.57M |
| H0046 |
Mental health services, not otherwise specified |
14,331 |
5,746 |
$972K |
| 90834 |
Psychotherapy, 45 minutes with patient |
9,203 |
4,091 |
$776K |
| D1120 |
Prophylaxis - child |
10,806 |
10,528 |
$499K |
| D0120 |
Periodic oral evaluation - established patient |
13,387 |
13,084 |
$373K |
| D1110 |
Prophylaxis - adult |
4,804 |
4,669 |
$292K |
| D1206 |
Topical application of fluoride varnish |
10,228 |
9,928 |
$263K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,690 |
1,326 |
$249K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,051 |
2,524 |
$235K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,682 |
1,902 |
$223K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,028 |
1,582 |
$208K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,702 |
1,362 |
$207K |
| D1351 |
Sealant - per tooth |
5,439 |
2,004 |
$197K |
| D0140 |
Limited oral evaluation - problem focused |
4,069 |
3,970 |
$183K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,055 |
450 |
$171K |
| 90887 |
|
5,833 |
3,221 |
$162K |
| D9920 |
|
2,018 |
1,853 |
$134K |
| D0272 |
Bitewings - two radiographic images |
4,713 |
4,520 |
$127K |
| D0330 |
Panoramic radiographic image |
1,637 |
1,584 |
$106K |
| D1208 |
Topical application of fluoride, excluding varnish |
4,130 |
4,023 |
$93K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,894 |
1,161 |
$81K |
| D0274 |
Bitewings - four radiographic images |
2,000 |
1,966 |
$81K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
951 |
807 |
$80K |
| D0220 |
Intraoral - periapical first radiographic image |
4,142 |
3,984 |
$65K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
678 |
500 |
$62K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
852 |
701 |
$59K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
2,545 |
2,355 |
$52K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
621 |
593 |
$51K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
580 |
486 |
$45K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
530 |
469 |
$44K |
| D9248 |
|
927 |
814 |
$40K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
507 |
457 |
$38K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,677 |
1,608 |
$29K |
| D2330 |
|
183 |
163 |
$29K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
393 |
350 |
$27K |
| D9110 |
|
378 |
362 |
$26K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
739 |
649 |
$24K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
316 |
283 |
$24K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,153 |
1,581 |
$21K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
244 |
87 |
$19K |
| 90791 |
Psychiatric diagnostic evaluation |
139 |
138 |
$19K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
275 |
254 |
$18K |
| 90461 |
|
871 |
833 |
$17K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
788 |
766 |
$14K |
| 99215 |
Prolong outpt/office vis |
93 |
88 |
$13K |
| D2140 |
|
123 |
90 |
$9K |
| D7280 |
|
13 |
13 |
$6K |
| 87430 |
|
408 |
392 |
$5K |
| 83655 |
|
358 |
352 |
$5K |
| D1354 |
|
271 |
105 |
$4K |
| D2332 |
|
135 |
125 |
$4K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
87 |
59 |
$3K |
| 97802 |
|
14 |
12 |
$2K |
| 90691 |
|
15 |
12 |
$2K |
| 87081 |
|
213 |
204 |
$2K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
31 |
29 |
$2K |
| 87070 |
|
121 |
117 |
$1K |
| D0145 |
Oral evaluation for a patient under three years of age |
28 |
28 |
$756.00 |
| D2335 |
|
75 |
74 |
$70.00 |
| 90688 |
|
39 |
39 |
$2.56 |
| D0210 |
Intraoral - complete series of radiographic images |
89 |
80 |
$0.00 |
| D2331 |
|
77 |
70 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
20 |
19 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
138 |
124 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
20 |
19 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
13 |
12 |
$0.00 |
| D9995 |
|
45 |
45 |
$0.00 |
| D1510 |
|
69 |
66 |
$0.00 |
| D0191 |
|
42 |
42 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
21 |
20 |
$0.00 |
| 80061 |
Lipid panel |
71 |
69 |
$0.00 |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
47 |
47 |
$0.00 |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
15 |
15 |
$0.00 |
| J0136 |
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg |
20 |
19 |
$0.00 |