| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31,908 |
26,491 |
$1.53M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,442 |
13,107 |
$1.08M |
| T1015 |
Clinic visit/encounter, all-inclusive |
39,078 |
31,048 |
$775K |
| D7140 |
Extraction, erupted tooth or exposed root |
6,326 |
2,067 |
$411K |
| D9999 |
Unspecified adjunctive procedure, by report |
10,538 |
8,618 |
$237K |
| D0999 |
Unspecified diagnostic procedure, by report |
1,654 |
1,476 |
$216K |
| D1110 |
Prophylaxis - adult |
4,676 |
4,170 |
$207K |
| D0330 |
Panoramic radiographic image |
3,336 |
3,010 |
$191K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,290 |
921 |
$107K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,159 |
2,863 |
$104K |
| D0120 |
Periodic oral evaluation - established patient |
4,648 |
4,168 |
$95K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,637 |
1,233 |
$87K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,695 |
1,468 |
$77K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,399 |
868 |
$72K |
| D0140 |
Limited oral evaluation - problem focused |
2,132 |
1,955 |
$71K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,095 |
1,595 |
$70K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
955 |
671 |
$64K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
897 |
721 |
$60K |
| D0274 |
Bitewings - four radiographic images |
1,766 |
1,564 |
$57K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,157 |
944 |
$54K |
| 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 |
4,760 |
3,588 |
$53K |
| 90791 |
Psychiatric diagnostic evaluation |
379 |
324 |
$33K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,172 |
2,590 |
$30K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,865 |
3,231 |
$26K |
| D2330 |
|
348 |
198 |
$25K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
229 |
197 |
$19K |
| 90686 |
|
1,498 |
1,293 |
$18K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,297 |
2,001 |
$17K |
| D2331 |
|
156 |
113 |
$16K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
661 |
566 |
$15K |
| 90674 |
|
714 |
555 |
$13K |
| D1206 |
Topical application of fluoride varnish |
580 |
508 |
$9K |
| D1120 |
Prophylaxis - child |
326 |
291 |
$7K |
| D4910 |
|
132 |
118 |
$6K |
| 36416 |
|
2,862 |
2,324 |
$6K |
| 90732 |
|
82 |
72 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
393 |
326 |
$5K |
| 90715 |
|
138 |
116 |
$4K |
| 0134A |
|
145 |
79 |
$4K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
675 |
584 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
51 |
44 |
$3K |
| 90677 |
|
13 |
12 |
$3K |
| 90480 |
|
222 |
121 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
191 |
172 |
$2K |
| 0064A |
|
100 |
79 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,237 |
1,016 |
$2K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
15 |
12 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
58 |
41 |
$1K |
| 81003 |
|
582 |
474 |
$1K |
| 81025 |
|
181 |
155 |
$757.24 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
25 |
24 |
$690.25 |
| 82962 |
|
241 |
216 |
$543.21 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
36 |
33 |
$487.79 |
| 80305 |
|
87 |
71 |
$397.01 |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
70 |
52 |
$361.37 |
| 82948 |
|
111 |
84 |
$227.11 |
| 93000 |
|
14 |
12 |
$154.69 |
| 91322 |
|
199 |
112 |
$134.50 |
| 81002 |
|
315 |
286 |
$125.31 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
17 |
13 |
$19.74 |
| 91313 |
|
141 |
77 |
$0.00 |
| 90756 |
|
18 |
18 |
$0.00 |
| 90651 |
|
14 |
13 |
$0.00 |
| 91301 |
|
19 |
13 |
$0.00 |
| 91306 |
|
103 |
80 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
73 |
57 |
$0.00 |