| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
45,610 |
41,403 |
$3.80M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
41,707 |
38,157 |
$2.52M |
| D0150 |
Comprehensive oral evaluation - new or established patient |
9,103 |
8,716 |
$539K |
| D0120 |
Periodic oral evaluation - established patient |
9,400 |
9,108 |
$370K |
| D1206 |
Topical application of fluoride varnish |
21,260 |
20,534 |
$357K |
| D1110 |
Prophylaxis - adult |
5,453 |
5,272 |
$321K |
| D1120 |
Prophylaxis - child |
6,410 |
6,219 |
$288K |
| D0140 |
Limited oral evaluation - problem focused |
5,186 |
4,859 |
$275K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
3,529 |
2,705 |
$241K |
| D0210 |
Intraoral - complete series of radiographic images |
4,800 |
4,582 |
$207K |
| D0230 |
Intraoral - periapical each additional radiographic image |
21,043 |
7,481 |
$170K |
| D0220 |
Intraoral - periapical first radiographic image |
12,026 |
11,332 |
$170K |
| 96158 |
|
4,371 |
3,390 |
$148K |
| D1351 |
Sealant - per tooth |
6,199 |
1,799 |
$140K |
| 96156 |
|
2,930 |
2,827 |
$133K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,350 |
2,191 |
$124K |
| D0274 |
Bitewings - four radiographic images |
5,923 |
5,708 |
$118K |
| 96150 |
|
2,176 |
2,115 |
$116K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,280 |
1,186 |
$110K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,800 |
1,261 |
$97K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
10,730 |
10,464 |
$95K |
| 99215 |
Prolong outpt/office vis |
840 |
773 |
$94K |
| D7140 |
Extraction, erupted tooth or exposed root |
716 |
399 |
$89K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
954 |
912 |
$88K |
| 90686 |
|
4,673 |
4,592 |
$84K |
| 96152 |
|
1,449 |
1,213 |
$71K |
| D0330 |
Panoramic radiographic image |
2,733 |
2,573 |
$61K |
| D0191 |
|
6,291 |
6,113 |
$43K |
| T1015 |
Clinic visit/encounter, all-inclusive |
241 |
209 |
$37K |
| 90832 |
Psychotherapy, 30 minutes with patient |
399 |
356 |
$37K |
| 99408 |
|
1,354 |
1,312 |
$34K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
295 |
283 |
$31K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
283 |
275 |
$26K |
| 36415 |
Collection of venous blood by venipuncture |
7,739 |
7,473 |
$24K |
| 0002A |
|
624 |
622 |
$24K |
| 0001A |
|
562 |
561 |
$21K |
| D9995 |
|
547 |
537 |
$21K |
| 91320 |
|
189 |
179 |
$16K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,990 |
1,948 |
$12K |
| D1354 |
|
1,135 |
504 |
$11K |
| 90791 |
Psychiatric diagnostic evaluation |
71 |
70 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
114 |
110 |
$10K |
| 0012A |
|
284 |
275 |
$10K |
| 99443 |
|
383 |
295 |
$9K |
| 0011A |
|
294 |
274 |
$9K |
| 0004A |
|
245 |
226 |
$8K |
| D0272 |
Bitewings - two radiographic images |
396 |
387 |
$7K |
| 90715 |
|
273 |
266 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,193 |
2,142 |
$6K |
| D0270 |
|
730 |
685 |
$6K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
98 |
97 |
$6K |
| 90651 |
|
238 |
237 |
$6K |
| 99442 |
|
233 |
207 |
$6K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
154 |
150 |
$5K |
| 99441 |
|
115 |
106 |
$5K |
| 99205 |
Prolong outpt/office vis |
28 |
28 |
$5K |
| 90480 |
|
157 |
149 |
$5K |
| 0064A |
|
100 |
99 |
$5K |
| 90656 |
|
258 |
257 |
$5K |
| 99385 |
|
55 |
54 |
$4K |
| 99188 |
|
381 |
377 |
$4K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
163 |
161 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
40 |
40 |
$4K |
| 98968 |
|
31 |
26 |
$4K |
| D4342 |
|
58 |
39 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
87 |
81 |
$3K |
| 0071A |
|
65 |
63 |
$3K |
| 0124A |
|
81 |
80 |
$3K |
| 90633 |
|
133 |
133 |
$3K |
| 0134A |
|
89 |
88 |
$3K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
32 |
25 |
$3K |
| 97165 |
|
44 |
41 |
$3K |
| 96160 |
|
1,420 |
1,377 |
$2K |
| 90739 |
|
21 |
21 |
$2K |
| 0054A |
|
49 |
48 |
$2K |
| 99607 |
|
130 |
127 |
$2K |
| 99406 |
|
103 |
91 |
$2K |
| 80305 |
|
228 |
174 |
$2K |
| D4910 |
|
27 |
26 |
$2K |
| 0072A |
|
30 |
29 |
$1K |
| D2330 |
|
22 |
12 |
$1K |
| 81025 |
|
233 |
219 |
$1K |
| 90661 |
|
58 |
58 |
$1K |
| D4341 |
|
17 |
13 |
$1K |
| 98966 |
|
24 |
21 |
$1K |
| 99177 |
|
357 |
355 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$999.50 |
| 90716 |
|
52 |
51 |
$988.20 |
| 90713 |
|
45 |
44 |
$856.44 |
| 90734 |
|
41 |
40 |
$856.44 |
| 90744 |
|
44 |
43 |
$823.77 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
47 |
45 |
$636.85 |
| 90674 |
|
29 |
29 |
$631.49 |
| 0031A |
|
14 |
12 |
$480.00 |
| 90619 |
|
25 |
25 |
$461.16 |
| 97535 |
Self-care/home management training, each 15 minutes |
133 |
100 |
$400.87 |
| 99605 |
|
14 |
14 |
$385.11 |
| D0240 |
|
47 |
25 |
$338.40 |
| 99606 |
|
14 |
13 |
$330.11 |
| 90707 |
|
19 |
19 |
$329.40 |
| 87210 |
|
71 |
70 |
$257.93 |
| 36416 |
|
340 |
338 |
$236.53 |
| 91319 |
|
12 |
12 |
$230.58 |
| 85018 |
|
110 |
109 |
$176.56 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
33 |
26 |
$173.13 |
| 81002 |
|
12 |
12 |
$22.05 |
| G0008 |
Administration of influenza virus vaccine |
21 |
19 |
$15.61 |
| 81003 |
|
14 |
13 |
$14.36 |
| D0603 |
|
12,789 |
12,235 |
$8.52 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
29 |
24 |
$4.85 |
| D0602 |
|
1,043 |
1,003 |
$0.50 |
| 91305 |
|
87 |
84 |
$0.15 |
| 91306 |
|
75 |
74 |
$0.15 |
| D0601 |
|
86 |
84 |
$0.11 |
| 91307 |
|
220 |
211 |
$0.09 |
| 91313 |
|
90 |
89 |
$0.08 |
| 91312 |
|
81 |
80 |
$0.04 |
| D1310 |
|
20,047 |
19,079 |
$0.00 |
| D1330 |
|
28,451 |
26,886 |
$0.00 |
| 3008F |
|
63 |
56 |
$0.00 |
| 3074F |
|
15 |
12 |
$0.00 |
| 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 |
14 |
12 |
$0.00 |
| 3078F |
|
29 |
26 |
$0.00 |
| 1160F |
|
81 |
73 |
$0.00 |
| 1159F |
|
81 |
73 |
$0.00 |
| 91300 |
|
33 |
33 |
$0.00 |