| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24,194 |
18,705 |
$742K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,734 |
3,047 |
$152K |
| D0140 |
Limited oral evaluation - problem focused |
4,333 |
4,013 |
$147K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,797 |
4,570 |
$145K |
| D1110 |
Prophylaxis - adult |
3,328 |
3,113 |
$145K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,983 |
1,075 |
$126K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,758 |
1,277 |
$95K |
| D1120 |
Prophylaxis - child |
1,711 |
1,661 |
$84K |
| D0274 |
Bitewings - four radiographic images |
3,066 |
2,929 |
$80K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,706 |
1,149 |
$68K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,310 |
986 |
$58K |
| D0210 |
Intraoral - complete series of radiographic images |
1,226 |
1,127 |
$55K |
| D0330 |
Panoramic radiographic image |
1,365 |
1,299 |
$52K |
| D0120 |
Periodic oral evaluation - established patient |
1,506 |
1,433 |
$36K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
500 |
447 |
$33K |
| D0220 |
Intraoral - periapical first radiographic image |
4,194 |
3,931 |
$32K |
| D1206 |
Topical application of fluoride varnish |
1,919 |
1,848 |
$29K |
| 90832 |
Psychotherapy, 30 minutes with patient |
652 |
477 |
$21K |
| D4341 |
|
350 |
176 |
$20K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
284 |
212 |
$17K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
854 |
736 |
$15K |
| D1208 |
Topical application of fluoride, excluding varnish |
936 |
904 |
$14K |
| 90791 |
Psychiatric diagnostic evaluation |
157 |
140 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
851 |
415 |
$10K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,590 |
1,002 |
$8K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
119 |
94 |
$8K |
| D2332 |
|
109 |
77 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
463 |
388 |
$6K |
| D0272 |
Bitewings - two radiographic images |
334 |
321 |
$6K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
69 |
66 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
128 |
119 |
$5K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
66 |
50 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
247 |
220 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
234 |
213 |
$2K |
| D2331 |
|
36 |
25 |
$2K |
| D2335 |
|
21 |
16 |
$1K |
| 90834 |
Psychotherapy, 45 minutes with patient |
30 |
25 |
$1K |
| 90674 |
|
105 |
98 |
$1K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
13 |
13 |
$1K |
| 90756 |
|
61 |
60 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
12 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
57 |
43 |
$897.12 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
53 |
44 |
$522.03 |
| 90686 |
|
25 |
25 |
$306.49 |
| D0270 |
|
15 |
14 |
$87.57 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
14 |
13 |
$77.65 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
15 |
13 |
$47.26 |
| 3074F |
|
4,416 |
3,390 |
$22.46 |
| 81002 |
|
28 |
27 |
$20.60 |
| 3078F |
|
3,788 |
2,910 |
$20.34 |
| D9986 |
|
122 |
102 |
$12.00 |
| 3079F |
|
2,384 |
1,907 |
$6.76 |
| 3077F |
|
865 |
662 |
$2.47 |
| 3075F |
|
747 |
612 |
$2.16 |
| 1159F |
|
13,399 |
10,119 |
$0.93 |
| 3080F |
|
190 |
152 |
$0.64 |
| 1160F |
|
4,000 |
3,290 |
$0.22 |
| 1125F |
|
14 |
14 |
$0.05 |
| 3011F |
|
182 |
147 |
$0.02 |
| 3044F |
|
38 |
33 |
$0.01 |
| D9310 |
|
1,130 |
1,100 |
$0.00 |
| 99000 |
|
140 |
129 |
$0.00 |
| 3725F |
|
48 |
40 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
15 |
13 |
$0.00 |