| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
95,769 |
68,642 |
$11.49M |
| 98960 |
|
3,495 |
1,177 |
$121K |
| D0330 |
Panoramic radiographic image |
207 |
129 |
$6K |
| 99051 |
|
317 |
274 |
$5K |
| D0274 |
Bitewings - four radiographic images |
128 |
87 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
64 |
27 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
93 |
46 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
60,677 |
45,974 |
$1K |
| 3074F |
|
14,469 |
10,163 |
$710.00 |
| 3078F |
|
10,297 |
7,251 |
$495.00 |
| 3079F |
|
6,704 |
5,072 |
$355.00 |
| 3075F |
|
2,775 |
2,160 |
$175.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
4,948 |
4,219 |
$62.18 |
| 88142 |
|
1,015 |
685 |
$12.02 |
| 81025 |
|
25,604 |
19,004 |
$10.12 |
| 3080F |
|
421 |
301 |
$10.00 |
| 90686 |
|
307 |
280 |
$5.25 |
| 81002 |
|
6,791 |
4,911 |
$5.08 |
| 3077F |
|
129 |
107 |
$5.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,300 |
1,132 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,261 |
5,170 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
7,507 |
6,302 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
201 |
177 |
$0.00 |
| 90633 |
|
898 |
818 |
$0.00 |
| 90648 |
|
537 |
489 |
$0.00 |
| 99173 |
|
7,368 |
6,049 |
$0.00 |
| 90658 |
|
541 |
462 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,233 |
1,143 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,579 |
1,852 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
787 |
709 |
$0.00 |
| 99201 |
|
228 |
207 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
462 |
393 |
$0.00 |
| 90734 |
|
1,027 |
941 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
353 |
308 |
$0.00 |
| 90649 |
|
186 |
173 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
116 |
87 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
276 |
97 |
$0.00 |
| 90715 |
|
476 |
440 |
$0.00 |
| 90700 |
|
26 |
26 |
$0.00 |
| 82948 |
|
56 |
36 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 90655 |
|
13 |
12 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
8,343 |
6,258 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
776 |
578 |
$0.00 |
| 3008F |
|
33,517 |
24,865 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
1,810 |
976 |
$0.00 |
| 92551 |
|
4,742 |
4,190 |
$0.00 |
| 85018 |
|
4,514 |
3,299 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,220 |
932 |
$0.00 |
| 90620 |
|
553 |
459 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
174 |
156 |
$0.00 |
| 90723 |
|
368 |
332 |
$0.00 |
| 90696 |
|
119 |
106 |
$0.00 |
| 88141 |
|
65 |
59 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
269 |
247 |
$0.00 |
| 97802 |
|
236 |
175 |
$0.00 |
| 90680 |
|
125 |
112 |
$0.00 |
| 90716 |
|
29 |
25 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
15 |
13 |
$0.00 |