| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
204,487 |
163,424 |
$40.27M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,186 |
12,368 |
$299K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,753 |
7,760 |
$264K |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,352 |
3,258 |
$89K |
| D7140 |
Extraction, erupted tooth or exposed root |
21,078 |
9,055 |
$74K |
| D0210 |
Intraoral - complete series of radiographic images |
21,370 |
20,369 |
$61K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
23,390 |
17,597 |
$51K |
| D1110 |
Prophylaxis - adult |
24,011 |
22,916 |
$50K |
| 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 |
1,941 |
1,584 |
$45K |
| D1351 |
Sealant - per tooth |
19,372 |
4,491 |
$42K |
| D1206 |
Topical application of fluoride varnish |
48,297 |
46,087 |
$37K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
21,687 |
20,577 |
$32K |
| 90834 |
Psychotherapy, 45 minutes with patient |
959 |
729 |
$31K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
17,633 |
12,858 |
$27K |
| D0120 |
Periodic oral evaluation - established patient |
30,523 |
29,205 |
$26K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,464 |
1,309 |
$25K |
| 90686 |
|
2,608 |
2,506 |
$22K |
| D1120 |
Prophylaxis - child |
15,149 |
14,556 |
$21K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,986 |
540 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
369 |
362 |
$20K |
| D0274 |
Bitewings - four radiographic images |
16,418 |
15,651 |
$18K |
| D5110 |
|
93 |
88 |
$15K |
| D0140 |
Limited oral evaluation - problem focused |
20,725 |
19,337 |
$14K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
4,578 |
3,838 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
253 |
241 |
$12K |
| D0220 |
Intraoral - periapical first radiographic image |
22,974 |
21,498 |
$9K |
| D4355 |
|
120 |
115 |
$6K |
| D5120 |
|
42 |
40 |
$6K |
| D0272 |
Bitewings - two radiographic images |
5,424 |
5,187 |
$6K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
99 |
93 |
$4K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
312 |
228 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
634 |
591 |
$4K |
| 90651 |
|
50 |
48 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
7,694 |
4,592 |
$3K |
| 90837 |
Psychotherapy, 53 minutes with patient |
54 |
39 |
$3K |
| D0240 |
|
2,179 |
1,325 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
272 |
226 |
$3K |
| D2331 |
|
1,346 |
997 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
45 |
44 |
$3K |
| D0330 |
Panoramic radiographic image |
922 |
870 |
$2K |
| D2335 |
|
169 |
115 |
$2K |
| 90656 |
|
156 |
149 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
24 |
24 |
$1K |
| 90670 |
|
31 |
31 |
$1K |
| 3008F |
|
156 |
146 |
$1K |
| 90785 |
|
227 |
171 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
81 |
43 |
$828.60 |
| 90746 |
|
13 |
12 |
$736.65 |
| 81003 |
|
546 |
317 |
$726.96 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
47 |
45 |
$720.09 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
33 |
31 |
$697.52 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
18 |
18 |
$574.56 |
| D2140 |
|
103 |
81 |
$528.54 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
15 |
12 |
$426.86 |
| 82962 |
|
175 |
137 |
$327.10 |
| 90715 |
|
15 |
14 |
$318.83 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
13 |
$293.25 |
| 90734 |
|
31 |
29 |
$193.03 |
| 85018 |
|
60 |
53 |
$120.78 |
| D0270 |
|
3,639 |
3,375 |
$82.56 |
| D5899 |
|
6,152 |
3,051 |
$0.00 |
| D2330 |
|
358 |
239 |
$0.00 |
| D7220 |
|
24 |
14 |
$0.00 |
| D4342 |
|
23 |
14 |
$0.00 |
| D0170 |
|
100 |
91 |
$0.00 |
| D4346 |
|
209 |
198 |
$0.00 |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
14 |
14 |
$0.00 |
| D7230 |
|
70 |
46 |
$0.00 |
| D7240 |
Removal of impacted tooth - completely bony |
36 |
27 |
$0.00 |
| D9110 |
|
153 |
136 |
$0.00 |
| D1354 |
|
12,289 |
2,901 |
$0.00 |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
1,307 |
914 |
$0.00 |
| D0191 |
|
1,509 |
1,354 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
983 |
843 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
632 |
367 |
$0.00 |
| D2940 |
|
144 |
101 |
$0.00 |
| D2332 |
|
92 |
74 |
$0.00 |
| D2394 |
|
84 |
74 |
$0.00 |