| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
20,003 |
16,072 |
$3.72M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
70,432 |
61,475 |
$1.54M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25,441 |
22,965 |
$444K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
9,166 |
8,956 |
$393K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29,157 |
28,382 |
$311K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
7,929 |
7,545 |
$279K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,339 |
6,210 |
$275K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,515 |
11,643 |
$229K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15,189 |
14,917 |
$189K |
| D0120 |
Periodic oral evaluation - established patient |
3,867 |
3,646 |
$174K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,656 |
3,571 |
$161K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,648 |
2,575 |
$110K |
| 92551 |
|
16,733 |
16,323 |
$56K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,333 |
1,303 |
$55K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,426 |
2,397 |
$31K |
| 99173 |
|
17,095 |
16,669 |
$28K |
| 3008F |
|
65,717 |
59,000 |
$26K |
| D1120 |
Prophylaxis - child |
2,717 |
2,687 |
$23K |
| D1110 |
Prophylaxis - adult |
2,071 |
2,043 |
$21K |
| 81025 |
|
5,785 |
5,479 |
$19K |
| 99385 |
|
636 |
607 |
$19K |
| 90474 |
|
2,193 |
2,175 |
$18K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,863 |
2,727 |
$18K |
| 59430 |
|
258 |
244 |
$17K |
| D1206 |
Topical application of fluoride varnish |
1,368 |
1,361 |
$13K |
| 99403 |
|
352 |
346 |
$13K |
| 0011A |
|
379 |
378 |
$12K |
| D0140 |
Limited oral evaluation - problem focused |
1,855 |
1,811 |
$12K |
| 0001A |
|
306 |
305 |
$11K |
| 0012A |
|
351 |
351 |
$11K |
| 99401 |
|
1,198 |
1,092 |
$10K |
| 90686 |
|
5,075 |
4,868 |
$10K |
| 90682 |
|
559 |
546 |
$10K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$10K |
| 99441 |
|
1,670 |
1,583 |
$9K |
| 0002A |
|
257 |
257 |
$9K |
| 0013A |
|
256 |
250 |
$9K |
| 81000 |
|
6,407 |
4,614 |
$9K |
| D0274 |
Bitewings - four radiographic images |
2,064 |
2,022 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,303 |
3,194 |
$7K |
| 99442 |
|
1,061 |
1,022 |
$7K |
| D0220 |
Intraoral - periapical first radiographic image |
4,538 |
3,796 |
$7K |
| 99386 |
|
165 |
160 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
575 |
570 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,025 |
932 |
$6K |
| 94760 |
|
23,657 |
21,614 |
$5K |
| D0210 |
Intraoral - complete series of radiographic images |
244 |
241 |
$5K |
| 81002 |
|
8,101 |
5,613 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,699 |
2,560 |
$4K |
| D1208 |
Topical application of fluoride, excluding varnish |
674 |
661 |
$4K |
| 99381 |
|
865 |
844 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
228 |
189 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
151 |
133 |
$3K |
| 0003A |
|
83 |
82 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
163 |
157 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
419 |
386 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
845 |
798 |
$2K |
| 0134A |
|
83 |
82 |
$2K |
| D0330 |
Panoramic radiographic image |
824 |
805 |
$2K |
| 82947 |
|
2,623 |
2,367 |
$2K |
| 0031A |
|
41 |
41 |
$2K |
| D1351 |
Sealant - per tooth |
206 |
88 |
$1K |
| 81005 |
|
2,679 |
2,658 |
$1K |
| 90715 |
|
392 |
375 |
$1K |
| 0072A |
|
48 |
47 |
$1K |
| D0602 |
|
230 |
230 |
$1K |
| 96127 |
|
145 |
138 |
$936.54 |
| 99384 |
|
28 |
26 |
$876.50 |
| D0603 |
|
212 |
208 |
$854.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
224 |
224 |
$793.75 |
| D7140 |
Extraction, erupted tooth or exposed root |
79 |
50 |
$777.25 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,153 |
1,040 |
$703.70 |
| D0180 |
|
45 |
42 |
$630.00 |
| 93270 |
|
64 |
62 |
$583.09 |
| 94010 |
|
59 |
59 |
$582.96 |
| 0071A |
|
20 |
19 |
$575.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,232 |
3,040 |
$533.21 |
| 99215 |
Prolong outpt/office vis |
44 |
41 |
$499.30 |
| 90662 |
|
143 |
111 |
$490.48 |
| 86580 |
|
125 |
115 |
$487.34 |
| 97802 |
|
35 |
35 |
$432.21 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
509 |
485 |
$400.00 |
| D0272 |
Bitewings - two radiographic images |
116 |
115 |
$350.00 |
| 90671 |
|
860 |
818 |
$326.97 |
| 90732 |
|
14 |
13 |
$273.00 |
| 3074F |
|
6,584 |
5,883 |
$185.00 |
| 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 |
1,540 |
1,305 |
$161.33 |
| 3078F |
|
5,610 |
4,975 |
$158.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,209 |
901 |
$155.00 |
| 90461 |
|
19 |
19 |
$149.18 |
| 99383 |
|
58 |
58 |
$132.40 |
| 90716 |
|
159 |
152 |
$90.00 |
| 3079F |
|
2,777 |
2,511 |
$82.00 |
| 90619 |
|
191 |
181 |
$60.41 |
| 90670 |
|
1,442 |
1,378 |
$59.00 |
| 90651 |
|
408 |
383 |
$51.05 |
| 93000 |
|
14 |
14 |
$45.54 |
| D0170 |
|
13 |
12 |
$36.00 |
| 3077F |
|
1,004 |
903 |
$30.00 |
| 3075F |
|
844 |
768 |
$26.00 |
| 90698 |
|
829 |
789 |
$22.00 |
| 90697 |
|
94 |
92 |
$20.11 |
| 90633 |
|
437 |
402 |
$18.00 |
| 90620 |
|
103 |
94 |
$15.03 |
| 99188 |
|
744 |
741 |
$15.00 |
| 3080F |
|
413 |
377 |
$12.00 |
| 90677 |
|
41 |
41 |
$4.24 |
| 90681 |
|
250 |
239 |
$4.01 |
| 90744 |
|
235 |
227 |
$4.00 |
| 90710 |
|
256 |
246 |
$4.00 |
| 90696 |
|
34 |
32 |
$3.00 |
| 90680 |
|
263 |
258 |
$3.00 |
| 3044F |
|
317 |
299 |
$3.00 |
| 90707 |
|
58 |
54 |
$2.00 |
| 90734 |
|
71 |
71 |
$2.00 |
| 90648 |
|
15 |
15 |
$1.00 |
| 90673 |
|
40 |
40 |
$0.38 |
| 1000F |
|
533 |
483 |
$0.00 |
| 90632 |
|
286 |
262 |
$0.00 |
| 1036F |
|
13 |
13 |
$0.00 |
| 0503F |
|
60 |
44 |
$0.00 |
| D9995 |
|
12 |
12 |
$0.00 |
| 3725F |
|
2,429 |
2,415 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
478 |
434 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
762 |
566 |
$0.00 |
| 3046F |
|
14 |
13 |
$0.00 |