| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
71,907 |
62,970 |
$17.14M |
| D0120 |
Periodic oral evaluation - established patient |
12,085 |
12,007 |
$388K |
| D7140 |
Extraction, erupted tooth or exposed root |
8,549 |
4,229 |
$373K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
5,503 |
5,090 |
$344K |
| D0140 |
Limited oral evaluation - problem focused |
8,429 |
8,239 |
$226K |
| D1110 |
Prophylaxis - adult |
4,547 |
4,521 |
$222K |
| D0220 |
Intraoral - periapical first radiographic image |
18,277 |
17,952 |
$179K |
| D0330 |
Panoramic radiographic image |
5,080 |
5,022 |
$166K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
3,285 |
2,602 |
$153K |
| D0274 |
Bitewings - four radiographic images |
13,825 |
13,716 |
$133K |
| D1206 |
Topical application of fluoride varnish |
7,210 |
7,145 |
$119K |
| D4341 |
|
3,302 |
2,603 |
$105K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,873 |
2,834 |
$94K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
2,758 |
2,627 |
$83K |
| D0230 |
Intraoral - periapical each additional radiographic image |
29,743 |
9,977 |
$63K |
| 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 |
3,564 |
2,084 |
$63K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
787 |
749 |
$53K |
| D1999 |
|
3,617 |
3,317 |
$46K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,866 |
1,189 |
$26K |
| D2331 |
|
354 |
273 |
$23K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,903 |
1,222 |
$17K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
302 |
241 |
$17K |
| 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 |
1,350 |
1,268 |
$15K |
| D0270 |
|
2,195 |
2,153 |
$15K |
| D4910 |
|
170 |
170 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
804 |
759 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
299 |
290 |
$9K |
| 90837 |
Psychotherapy, 53 minutes with patient |
457 |
319 |
$7K |
| 90832 |
Psychotherapy, 30 minutes with patient |
437 |
284 |
$6K |
| D1120 |
Prophylaxis - child |
134 |
134 |
$3K |
| 87428 |
|
42 |
42 |
$2K |
| D2330 |
|
51 |
41 |
$2K |
| D2394 |
|
26 |
26 |
$2K |
| D0272 |
Bitewings - two radiographic images |
622 |
617 |
$2K |
| D2332 |
|
13 |
12 |
$1K |
| D9992 |
|
99 |
95 |
$1K |
| D4342 |
|
34 |
16 |
$854.42 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
28 |
27 |
$597.80 |
| D3221 |
|
12 |
12 |
$496.80 |
| 96127 |
|
45 |
43 |
$0.00 |
| 3074F |
|
95 |
92 |
$0.00 |
| D0603 |
|
12 |
12 |
$0.00 |
| 3078F |
|
119 |
114 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
30 |
30 |
$0.00 |