| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
48,633 |
36,244 |
$3.92M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21,286 |
11,214 |
$674K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
23,737 |
13,106 |
$488K |
| 90837 |
Psychotherapy, 53 minutes with patient |
4,976 |
1,696 |
$193K |
| D0330 |
Panoramic radiographic image |
4,094 |
2,886 |
$67K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,633 |
3,260 |
$43K |
| D1110 |
Prophylaxis - adult |
3,213 |
2,292 |
$38K |
| 80305 |
|
6,991 |
2,659 |
$36K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
506 |
273 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,519 |
1,080 |
$19K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,022 |
561 |
$17K |
| D0140 |
Limited oral evaluation - problem focused |
2,381 |
1,661 |
$16K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
856 |
514 |
$14K |
| D0274 |
Bitewings - four radiographic images |
3,439 |
2,650 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,551 |
857 |
$11K |
| D0220 |
Intraoral - periapical first radiographic image |
6,545 |
4,675 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
402 |
221 |
$11K |
| D0120 |
Periodic oral evaluation - established patient |
2,132 |
1,541 |
$10K |
| 90674 |
|
799 |
437 |
$10K |
| 99442 |
|
975 |
478 |
$10K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,036 |
1,475 |
$9K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,726 |
3,117 |
$8K |
| 99441 |
|
1,405 |
689 |
$7K |
| 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 |
1,170 |
921 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,982 |
1,187 |
$7K |
| D1120 |
Prophylaxis - child |
738 |
504 |
$6K |
| 90686 |
|
657 |
391 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
229 |
199 |
$4K |
| 99215 |
Prolong outpt/office vis |
56 |
37 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
76 |
53 |
$3K |
| 81025 |
|
742 |
278 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
51 |
27 |
$2K |
| 90688 |
|
229 |
124 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
33 |
25 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
193 |
57 |
$1K |
| D0272 |
Bitewings - two radiographic images |
585 |
410 |
$1K |
| D7140 |
Extraction, erupted tooth or exposed root |
100 |
55 |
$966.23 |
| 90832 |
Psychotherapy, 30 minutes with patient |
34 |
15 |
$695.94 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
12 |
$686.72 |
| 0031A |
|
24 |
17 |
$645.66 |
| D0210 |
Intraoral - complete series of radiographic images |
97 |
38 |
$530.88 |
| 90656 |
|
18 |
17 |
$319.62 |
| 81002 |
|
279 |
187 |
$259.04 |
| 3044F |
|
93 |
53 |
$40.00 |
| G0008 |
Administration of influenza virus vaccine |
47 |
33 |
$24.67 |
| 91303 |
|
24 |
17 |
$0.17 |
| 3078F |
|
17,334 |
8,956 |
$0.00 |
| 4004F |
|
17,472 |
8,462 |
$0.00 |
| 3077F |
|
1,424 |
701 |
$0.00 |
| 90658 |
|
25 |
12 |
$0.00 |
| 1036F |
|
15,936 |
8,256 |
$0.00 |
| 3075F |
|
4,397 |
2,296 |
$0.00 |
| 3079F |
|
11,783 |
6,088 |
$0.00 |
| 3080F |
|
1,025 |
509 |
$0.00 |
| 3074F |
|
22,480 |
11,506 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
24 |
24 |
$0.00 |