| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38,038 |
22,778 |
$5.06M |
| 90834 |
Psychotherapy, 45 minutes with patient |
17,434 |
4,295 |
$3.09M |
| D1110 |
Prophylaxis - adult |
15,625 |
7,159 |
$1.41M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
5,543 |
3,360 |
$712K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
9,938 |
4,121 |
$561K |
| D0120 |
Periodic oral evaluation - established patient |
8,061 |
6,774 |
$413K |
| D0274 |
Bitewings - four radiographic images |
6,978 |
3,343 |
$395K |
| 36415 |
Collection of venous blood by venipuncture |
6,826 |
3,568 |
$391K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,878 |
2,926 |
$357K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,675 |
1,595 |
$343K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
3,350 |
1,570 |
$329K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,620 |
1,380 |
$301K |
| D0140 |
Limited oral evaluation - problem focused |
2,768 |
1,584 |
$296K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,097 |
1,247 |
$290K |
| D1120 |
Prophylaxis - child |
4,025 |
2,772 |
$264K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,023 |
1,053 |
$237K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,408 |
517 |
$229K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
1,282 |
598 |
$215K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,536 |
980 |
$210K |
| 90791 |
Psychiatric diagnostic evaluation |
1,118 |
763 |
$205K |
| D1206 |
Topical application of fluoride varnish |
4,155 |
1,953 |
$198K |
| 99177 |
|
2,595 |
1,031 |
$161K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,411 |
636 |
$146K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
961 |
443 |
$144K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
1,271 |
700 |
$143K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
811 |
358 |
$67K |
| D2330 |
|
690 |
346 |
$66K |
| 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 |
1,252 |
397 |
$64K |
| D9110 |
|
526 |
359 |
$56K |
| 0011A |
|
648 |
225 |
$43K |
| D0220 |
Intraoral - periapical first radiographic image |
759 |
431 |
$37K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
527 |
316 |
$35K |
| D2140 |
|
340 |
176 |
$34K |
| 90461 |
|
725 |
430 |
$33K |
| 0001A |
|
809 |
751 |
$30K |
| D2999 |
|
165 |
105 |
$29K |
| 0002A |
|
773 |
762 |
$26K |
| D0272 |
Bitewings - two radiographic images |
888 |
708 |
$23K |
| 99441 |
|
117 |
80 |
$19K |
| D2751 |
Crown - porcelain fused to predominantly base metal |
64 |
38 |
$18K |
| D9997 |
|
207 |
85 |
$14K |
| 99381 |
|
70 |
55 |
$14K |
| 90697 |
|
283 |
58 |
$14K |
| 90686 |
|
494 |
395 |
$11K |
| D0330 |
Panoramic radiographic image |
149 |
75 |
$11K |
| 0012A |
|
333 |
295 |
$10K |
| 91301 |
|
299 |
236 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
97 |
42 |
$7K |
| D0270 |
|
87 |
43 |
$6K |
| 90700 |
|
124 |
26 |
$6K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
240 |
62 |
$6K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
30 |
24 |
$6K |
| D1208 |
Topical application of fluoride, excluding varnish |
124 |
65 |
$5K |
| 99383 |
|
74 |
16 |
$5K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
32 |
12 |
$4K |
| D1351 |
Sealant - per tooth |
64 |
29 |
$3K |
| D2331 |
|
21 |
12 |
$3K |
| 0064A |
|
69 |
69 |
$2K |
| D0251 |
|
385 |
382 |
$2K |
| 0003A |
|
54 |
54 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
37 |
13 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
41 |
12 |
$2K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
27 |
14 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
21 |
15 |
$2K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
36 |
27 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
64 |
64 |
$729.17 |
| 0072A |
|
18 |
18 |
$640.00 |
| 90688 |
|
23 |
17 |
$624.60 |
| 91300 |
|
658 |
589 |
$247.47 |
| 90656 |
|
29 |
29 |
$156.45 |
| 92015 |
Determination of refractive state |
12 |
12 |
$139.03 |
| 90674 |
|
36 |
36 |
$64.74 |
| D0601 |
|
19 |
19 |
$19.00 |
| D0602 |
|
13 |
13 |
$13.00 |
| D0603 |
|
16 |
15 |
$12.00 |
| 91307 |
|
36 |
30 |
$0.17 |
| 91306 |
|
53 |
53 |
$0.01 |