| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
31,320 |
17,056 |
$4.49M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16,893 |
15,812 |
$3.11M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,504 |
14,353 |
$3.06M |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,737 |
1,662 |
$320K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,214 |
1,249 |
$254K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,187 |
1,118 |
$223K |
| 99215 |
Prolong outpt/office vis |
1,227 |
1,162 |
$222K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,612 |
1,569 |
$197K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,022 |
988 |
$193K |
| D1206 |
Topical application of fluoride varnish |
13,243 |
10,220 |
$140K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
1,418 |
492 |
$119K |
| D1120 |
Prophylaxis - child |
6,869 |
6,832 |
$106K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,008 |
878 |
$101K |
| D7140 |
Extraction, erupted tooth or exposed root |
3,860 |
1,558 |
$96K |
| D1351 |
Sealant - per tooth |
4,723 |
1,591 |
$89K |
| 90686 |
|
7,632 |
7,427 |
$88K |
| 90834 |
Psychotherapy, 45 minutes with patient |
554 |
340 |
$87K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
451 |
435 |
$82K |
| D0210 |
Intraoral - complete series of radiographic images |
1,722 |
1,702 |
$76K |
| D0120 |
Periodic oral evaluation - established patient |
5,901 |
5,881 |
$75K |
| 36415 |
Collection of venous blood by venipuncture |
4,586 |
4,229 |
$73K |
| D1999 |
|
7,689 |
6,939 |
$70K |
| H0046 |
Mental health services, not otherwise specified |
1,466 |
1,013 |
$64K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,059 |
4,035 |
$59K |
| 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 |
1,883 |
1,564 |
$58K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
345 |
329 |
$47K |
| 92552 |
|
2,514 |
2,439 |
$47K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,168 |
831 |
$42K |
| D1110 |
Prophylaxis - adult |
1,382 |
1,381 |
$33K |
| 0011A |
|
576 |
568 |
$33K |
| 36416 |
|
2,375 |
2,137 |
$32K |
| D0272 |
Bitewings - two radiographic images |
3,454 |
3,447 |
$30K |
| J3490 |
Unclassified drugs |
346 |
334 |
$26K |
| 0002A |
|
690 |
685 |
$26K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
539 |
409 |
$25K |
| 0012A |
|
533 |
531 |
$23K |
| 0001A |
|
622 |
609 |
$22K |
| 83655 |
|
2,103 |
1,866 |
$22K |
| D0145 |
Oral evaluation for a patient under three years of age |
789 |
785 |
$21K |
| D0274 |
Bitewings - four radiographic images |
3,624 |
3,615 |
$20K |
| 85018 |
|
8,737 |
7,907 |
$19K |
| D0240 |
|
1,779 |
1,588 |
$18K |
| D0999 |
Unspecified diagnostic procedure, by report |
1,141 |
937 |
$14K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,739 |
1,650 |
$13K |
| D0140 |
Limited oral evaluation - problem focused |
1,319 |
1,311 |
$12K |
| 90670 |
|
1,011 |
985 |
$11K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,246 |
525 |
$10K |
| 90791 |
Psychiatric diagnostic evaluation |
60 |
52 |
$10K |
| 91320 |
|
152 |
145 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
64 |
63 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,602 |
1,559 |
$8K |
| 90648 |
|
789 |
767 |
$8K |
| 99173 |
|
2,583 |
2,501 |
$8K |
| 94010 |
|
177 |
177 |
$8K |
| 90651 |
|
687 |
667 |
$8K |
| 0072A |
|
199 |
197 |
$7K |
| D0330 |
Panoramic radiographic image |
2,417 |
2,406 |
$7K |
| 0071A |
|
176 |
175 |
$6K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
714 |
683 |
$6K |
| D9420 |
|
86 |
67 |
$6K |
| 0064A |
|
169 |
167 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
5,478 |
5,443 |
$6K |
| 97803 |
|
46 |
40 |
$6K |
| 90723 |
|
540 |
523 |
$5K |
| 90750 |
|
52 |
52 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
12,380 |
3,933 |
$4K |
| 90633 |
|
382 |
368 |
$4K |
| 0004A |
|
91 |
88 |
$3K |
| 3008F |
|
7,097 |
6,670 |
$3K |
| 80061 |
Lipid panel |
263 |
251 |
$3K |
| 81025 |
|
353 |
339 |
$3K |
| 90480 |
|
231 |
217 |
$3K |
| 90685 |
|
252 |
247 |
$3K |
| 0124A |
|
93 |
87 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
272 |
265 |
$2K |
| 97802 |
|
12 |
12 |
$2K |
| 87210 |
|
388 |
365 |
$2K |
| 90734 |
|
182 |
172 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
132 |
116 |
$2K |
| 82962 |
|
663 |
629 |
$2K |
| 81002 |
|
504 |
468 |
$2K |
| 0111A |
|
43 |
43 |
$2K |
| 90715 |
|
118 |
113 |
$2K |
| 0054A |
|
46 |
42 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
98 |
87 |
$1K |
| 90681 |
|
107 |
105 |
$1K |
| 90688 |
|
77 |
76 |
$813.90 |
| 3074F |
|
600 |
566 |
$651.52 |
| D4355 |
|
18 |
18 |
$644.00 |
| 90619 |
|
56 |
56 |
$591.84 |
| 0112A |
|
15 |
15 |
$554.10 |
| 90620 |
|
49 |
44 |
$480.48 |
| 3075F |
|
220 |
216 |
$460.01 |
| 98968 |
|
14 |
13 |
$453.88 |
| 90710 |
|
40 |
40 |
$427.16 |
| 0154A |
|
12 |
12 |
$424.71 |
| 0073A |
|
14 |
13 |
$406.34 |
| D4341 |
|
38 |
24 |
$337.77 |
| 91319 |
|
30 |
30 |
$335.61 |
| 90677 |
|
28 |
28 |
$294.84 |
| 3079F |
|
522 |
499 |
$212.27 |
| 3077F |
|
224 |
206 |
$211.70 |
| G0008 |
Administration of influenza virus vaccine |
15 |
13 |
$206.97 |
| 90744 |
|
17 |
17 |
$185.64 |
| 90713 |
|
17 |
17 |
$185.64 |
| 90697 |
|
12 |
12 |
$131.76 |
| 90656 |
|
12 |
12 |
$131.04 |
| 86580 |
|
14 |
14 |
$103.61 |
| D0270 |
|
55 |
55 |
$30.39 |
| 3078F |
|
507 |
488 |
$0.90 |
| 91305 |
|
168 |
160 |
$0.00 |
| 91301 |
|
1,107 |
1,068 |
$0.00 |
| 91307 |
|
509 |
471 |
$0.00 |
| D9995 |
|
122 |
122 |
$0.00 |
| D0170 |
|
30 |
30 |
$0.00 |
| 3080F |
|
46 |
45 |
$0.00 |
| 3044F |
|
29 |
29 |
$0.00 |
| 91306 |
|
170 |
168 |
$0.00 |
| 91315 |
|
12 |
12 |
$0.00 |
| D1330 |
|
20 |
20 |
$0.00 |
| 91300 |
|
1,402 |
1,234 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
222 |
218 |
$0.00 |
| 91311 |
|
64 |
64 |
$0.00 |
| 91312 |
|
87 |
83 |
$0.00 |
| 90461 |
|
14 |
14 |
$0.00 |