| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
113,457 |
93,543 |
$8.16M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
75,054 |
42,449 |
$1.64M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
60,443 |
24,107 |
$656K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15,555 |
9,340 |
$461K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14,160 |
8,595 |
$370K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
9,920 |
5,967 |
$282K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,553 |
2,447 |
$151K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,505 |
2,726 |
$143K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
6,018 |
2,919 |
$143K |
| D0120 |
Periodic oral evaluation - established patient |
20,456 |
13,633 |
$140K |
| D1110 |
Prophylaxis - adult |
10,068 |
6,830 |
$131K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
9,531 |
5,655 |
$129K |
| D1120 |
Prophylaxis - child |
16,984 |
11,393 |
$122K |
| D1208 |
Topical application of fluoride, excluding varnish |
20,393 |
13,593 |
$115K |
| D0330 |
Panoramic radiographic image |
7,180 |
5,055 |
$109K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
4,751 |
2,281 |
$104K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14,092 |
8,455 |
$89K |
| D7140 |
Extraction, erupted tooth or exposed root |
3,653 |
1,816 |
$81K |
| 92551 |
|
20,356 |
12,236 |
$64K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
8,001 |
5,480 |
$59K |
| D0140 |
Limited oral evaluation - problem focused |
5,877 |
3,703 |
$58K |
| 87428 |
|
3,100 |
1,691 |
$52K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
3,152 |
1,641 |
$52K |
| D1351 |
Sealant - per tooth |
5,878 |
1,535 |
$52K |
| D0274 |
Bitewings - four radiographic images |
7,242 |
4,924 |
$51K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,112 |
606 |
$33K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
1,024 |
579 |
$30K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
279 |
258 |
$27K |
| 90791 |
Psychiatric diagnostic evaluation |
458 |
265 |
$27K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,219 |
1,068 |
$20K |
| D0272 |
Bitewings - two radiographic images |
4,973 |
3,302 |
$17K |
| 99173 |
|
12,064 |
6,851 |
$15K |
| 99381 |
|
608 |
435 |
$15K |
| D0220 |
Intraoral - periapical first radiographic image |
4,957 |
3,079 |
$12K |
| D2140 |
|
863 |
533 |
$10K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
942 |
650 |
$6K |
| D2160 |
|
327 |
236 |
$6K |
| 90670 |
|
8,360 |
5,373 |
$6K |
| D2331 |
|
189 |
91 |
$5K |
| 90686 |
|
11,919 |
6,780 |
$5K |
| D0210 |
Intraoral - complete series of radiographic images |
156 |
134 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
237 |
124 |
$4K |
| D0270 |
|
1,939 |
1,201 |
$4K |
| 85018 |
|
3,600 |
2,267 |
$4K |
| 90698 |
|
5,718 |
3,726 |
$3K |
| 99383 |
|
92 |
67 |
$3K |
| 0072A |
|
56 |
56 |
$3K |
| 90680 |
|
4,229 |
2,800 |
$2K |
| 0071A |
|
40 |
40 |
$2K |
| 90744 |
|
2,517 |
1,687 |
$1K |
| 90633 |
|
2,458 |
1,620 |
$1K |
| 90710 |
|
1,427 |
928 |
$874.31 |
| D2330 |
|
17 |
12 |
$614.52 |
| D0230 |
Intraoral - periapical each additional radiographic image |
256 |
108 |
$536.64 |
| D2332 |
|
21 |
14 |
$536.34 |
| 90671 |
|
631 |
414 |
$507.13 |
| 90651 |
|
864 |
528 |
$435.23 |
| 90685 |
|
840 |
674 |
$430.00 |
| 87807 |
|
81 |
42 |
$423.83 |
| 96127 |
|
205 |
116 |
$400.51 |
| 90619 |
|
162 |
103 |
$150.53 |
| 90734 |
|
453 |
270 |
$110.00 |
| 90700 |
|
147 |
103 |
$100.00 |
| 90648 |
|
131 |
87 |
$70.00 |
| 90696 |
|
77 |
52 |
$70.00 |
| 90713 |
|
53 |
33 |
$30.00 |
| 90715 |
|
46 |
25 |
$20.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
31 |
15 |
$2.30 |
| 1160F |
|
24,830 |
13,695 |
$0.00 |
| 3078F |
|
14,821 |
8,498 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
44,185 |
39,962 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
14,763 |
8,458 |
$0.00 |
| 1159F |
|
24,829 |
13,691 |
$0.00 |
| 81003 |
|
151 |
132 |
$0.00 |
| 1126F |
|
686 |
607 |
$0.00 |
| 3074F |
|
14,984 |
8,583 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
7,346 |
6,186 |
$0.00 |
| 1036F |
|
9,433 |
5,598 |
$0.00 |
| 3008F |
|
40,370 |
21,977 |
$0.00 |
| 90716 |
|
40 |
24 |
$0.00 |
| D1330 |
|
17 |
16 |
$0.00 |
| 90656 |
|
157 |
153 |
$0.00 |
| D1310 |
|
21 |
20 |
$0.00 |
| 1125F |
|
63 |
28 |
$0.00 |