| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
689 |
602 |
$460K |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,153 |
2,098 |
$169K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,111 |
3,558 |
$104K |
| D7140 |
Extraction, erupted tooth or exposed root |
921 |
430 |
$74K |
| D0140 |
Limited oral evaluation - problem focused |
2,774 |
2,576 |
$68K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
675 |
357 |
$64K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,921 |
1,671 |
$63K |
| D8670 |
Periodic orthodontic treatment visit |
528 |
430 |
$59K |
| D1120 |
Prophylaxis - child |
2,132 |
2,015 |
$57K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,151 |
1,029 |
$49K |
| D1206 |
Topical application of fluoride varnish |
3,049 |
2,899 |
$47K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,466 |
1,408 |
$33K |
| D0120 |
Periodic oral evaluation - established patient |
1,996 |
1,912 |
$33K |
| D1110 |
Prophylaxis - adult |
1,074 |
1,004 |
$29K |
| D9420 |
|
115 |
107 |
$25K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
498 |
445 |
$24K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
567 |
536 |
$21K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
510 |
458 |
$19K |
| 90837 |
Psychotherapy, 53 minutes with patient |
216 |
137 |
$19K |
| D0272 |
Bitewings - two radiographic images |
795 |
746 |
$17K |
| D0330 |
Panoramic radiographic image |
375 |
364 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
734 |
657 |
$16K |
| H0022 |
Alcohol and/or drug intervention service (planned facilitation) |
315 |
168 |
$12K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
50 |
27 |
$11K |
| D0220 |
Intraoral - periapical first radiographic image |
1,033 |
956 |
$11K |
| D1351 |
Sealant - per tooth |
445 |
182 |
$11K |
| D0999 |
Unspecified diagnostic procedure, by report |
571 |
557 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
94 |
91 |
$6K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
525 |
212 |
$6K |
| D0240 |
|
228 |
133 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
152 |
136 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
533 |
443 |
$5K |
| D8660 |
|
85 |
63 |
$4K |
| D0274 |
Bitewings - four radiographic images |
236 |
213 |
$4K |
| 0012A |
|
152 |
151 |
$4K |
| 90686 |
|
394 |
366 |
$4K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
165 |
64 |
$3K |
| 0064A |
|
97 |
89 |
$3K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
156 |
77 |
$3K |
| 99000 |
|
1,123 |
973 |
$2K |
| 99173 |
|
122 |
114 |
$2K |
| 0011A |
|
123 |
116 |
$2K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
37 |
24 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
40 |
25 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
102 |
85 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
26 |
26 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
24 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
15 |
14 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
212 |
90 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
148 |
138 |
$1K |
| 92551 |
|
94 |
89 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
18 |
16 |
$975.68 |
| 80305 |
|
72 |
24 |
$830.04 |
| D0470 |
|
15 |
15 |
$633.50 |
| 3008F |
|
73 |
65 |
$570.00 |
| 0134A |
|
36 |
31 |
$534.24 |
| 0054A |
|
17 |
14 |
$496.08 |
| D0170 |
|
20 |
19 |
$363.50 |
| D9910 |
|
20 |
12 |
$352.34 |
| 99441 |
|
58 |
28 |
$233.09 |
| 86710 |
|
15 |
14 |
$210.84 |
| 90688 |
|
15 |
14 |
$200.84 |
| 86703 |
|
15 |
13 |
$169.20 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
32 |
25 |
$126.29 |
| 90656 |
|
15 |
15 |
$58.88 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
15 |
14 |
$51.78 |
| 36415 |
Collection of venous blood by venipuncture |
1,005 |
870 |
$12.58 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
22 |
18 |
$0.00 |
| D1310 |
|
21 |
20 |
$0.00 |
| 96160 |
|
13 |
13 |
$0.00 |