| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
162,985 |
94,572 |
$87.89M |
| D9999 |
Unspecified adjunctive procedure, by report |
10,656 |
9,692 |
$5.85M |
| D8999 |
|
64 |
36 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
46,927 |
40,985 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,956 |
7,108 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
14 |
$1K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
498 |
256 |
$519.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12,595 |
10,668 |
$408.57 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
266 |
258 |
$241.86 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,240 |
1,208 |
$217.56 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,228 |
1,203 |
$133.11 |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,610 |
1,295 |
$82.09 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,098 |
1,051 |
$43.57 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
264 |
262 |
$13.40 |
| 99442 |
|
131 |
110 |
$1.33 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
248 |
85 |
$0.00 |
| 81025 |
|
12 |
12 |
$0.00 |
| 81003 |
|
2,104 |
1,495 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
680 |
628 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
554 |
539 |
$0.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,249 |
1,229 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
239 |
222 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
551 |
526 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
100 |
94 |
$0.00 |
| D0191 |
|
385 |
383 |
$0.00 |
| 91312 |
|
30 |
30 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
915 |
883 |
$0.00 |
| 91300 |
|
1,312 |
1,184 |
$0.00 |
| 0071A |
|
36 |
36 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
41 |
41 |
$0.00 |
| D1110 |
Prophylaxis - adult |
56 |
55 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
177 |
169 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
318 |
179 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
277 |
175 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
158 |
157 |
$0.00 |
| 92015 |
Determination of refractive state |
35 |
35 |
$0.00 |
| D0190 |
|
339 |
320 |
$0.00 |
| D1120 |
Prophylaxis - child |
50 |
50 |
$0.00 |
| 90849 |
|
53 |
31 |
$0.00 |
| 85014 |
|
41 |
37 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
31 |
31 |
$0.00 |
| 99201 |
|
13 |
13 |
$0.00 |
| 99401 |
|
14 |
12 |
$0.00 |
| D8660 |
|
33 |
33 |
$0.00 |
| D0330 |
Panoramic radiographic image |
17 |
14 |
$0.00 |
| 98960 |
|
412 |
116 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
35 |
32 |
$0.00 |
| 80061 |
Lipid panel |
13 |
13 |
$0.00 |
| 86703 |
|
23 |
23 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12 |
12 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
374 |
258 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
1,859 |
1,750 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
7,055 |
6,603 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
263 |
185 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
1,116 |
1,066 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
229 |
223 |
$0.00 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,880 |
1,796 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
58 |
58 |
$0.00 |
| 91305 |
|
504 |
490 |
$0.00 |
| D1330 |
|
457 |
456 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,377 |
1,342 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
305 |
176 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
366 |
241 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
235 |
217 |
$0.00 |
| 92002 |
|
44 |
38 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
175 |
171 |
$0.00 |
| 91307 |
|
603 |
544 |
$0.00 |
| 90651 |
|
32 |
27 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12 |
12 |
$0.00 |
| 99510 |
|
326 |
168 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
105 |
95 |
$0.00 |
| 91301 |
|
57 |
57 |
$0.00 |
| 99000 |
|
22 |
22 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
172 |
169 |
$0.00 |
| 81005 |
|
31 |
31 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
156 |
136 |
$0.00 |
| D1351 |
Sealant - per tooth |
69 |
32 |
$0.00 |
| 99441 |
|
108 |
90 |
$0.00 |
| 90656 |
|
22 |
18 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
13 |
$0.00 |
| 81015 |
|
14 |
14 |
$0.00 |
| H0038 |
Self-help/peer services, per 15 minutes |
16 |
13 |
$0.00 |
| 90619 |
|
12 |
12 |
$0.00 |
| D8670 |
Periodic orthodontic treatment visit |
24 |
13 |
$0.00 |