| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
76,920 |
64,868 |
$31.09M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28,765 |
26,054 |
$1.21M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,356 |
7,650 |
$413K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,817 |
1,649 |
$152K |
| D0140 |
Limited oral evaluation - problem focused |
5,882 |
5,450 |
$141K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
8,108 |
7,300 |
$95K |
| D1206 |
Topical application of fluoride varnish |
6,724 |
6,018 |
$94K |
| 80050 |
General health panel |
2,268 |
2,085 |
$71K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,318 |
992 |
$53K |
| D0220 |
Intraoral - periapical first radiographic image |
6,195 |
5,806 |
$52K |
| 90686 |
|
3,969 |
3,794 |
$46K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,028 |
3,723 |
$46K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
621 |
599 |
$45K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,410 |
1,368 |
$43K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
4,137 |
3,572 |
$36K |
| 0002A |
|
941 |
851 |
$24K |
| 36415 |
Collection of venous blood by venipuncture |
9,422 |
8,528 |
$24K |
| D0210 |
Intraoral - complete series of radiographic images |
582 |
569 |
$23K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,487 |
2,389 |
$23K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
244 |
238 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
733 |
679 |
$19K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
301 |
213 |
$19K |
| 99441 |
|
784 |
638 |
$19K |
| D1351 |
Sealant - per tooth |
2,694 |
397 |
$18K |
| 0001A |
|
969 |
921 |
$18K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,135 |
2,019 |
$16K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
533 |
509 |
$15K |
| D0330 |
Panoramic radiographic image |
914 |
865 |
$13K |
| 91320 |
|
138 |
136 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
176 |
174 |
$10K |
| 0004A |
|
271 |
256 |
$10K |
| 90480 |
|
270 |
267 |
$9K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
256 |
250 |
$9K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
248 |
244 |
$9K |
| 0124A |
|
254 |
241 |
$8K |
| 80061 |
Lipid panel |
627 |
604 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
86 |
82 |
$7K |
| 0071A |
|
144 |
141 |
$5K |
| 90674 |
|
337 |
321 |
$5K |
| D1110 |
Prophylaxis - adult |
151 |
140 |
$5K |
| 80053 |
Comprehensive metabolic panel |
735 |
659 |
$4K |
| 0072A |
|
106 |
105 |
$4K |
| 92015 |
Determination of refractive state |
444 |
440 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
859 |
772 |
$4K |
| 0054A |
|
138 |
128 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
254 |
142 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
41 |
41 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
41 |
40 |
$3K |
| 90678 |
|
12 |
12 |
$3K |
| 92250 |
|
180 |
174 |
$3K |
| 99442 |
|
87 |
74 |
$3K |
| 81025 |
|
490 |
461 |
$3K |
| D4341 |
|
87 |
61 |
$3K |
| 98966 |
|
222 |
183 |
$3K |
| 0012A |
|
95 |
93 |
$3K |
| 91322 |
|
30 |
30 |
$2K |
| 90677 |
|
12 |
12 |
$2K |
| 90715 |
|
160 |
156 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
97 |
86 |
$2K |
| 84443 |
Thyroid stimulating hormone (TSH) |
243 |
212 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
137 |
126 |
$2K |
| 90632 |
|
35 |
35 |
$2K |
| 90651 |
|
273 |
262 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
521 |
504 |
$1K |
| 90688 |
|
113 |
106 |
$1K |
| 0011A |
|
127 |
125 |
$1K |
| 81001 |
|
486 |
464 |
$1K |
| D3221 |
|
29 |
27 |
$1K |
| 81003 |
|
752 |
696 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
524 |
198 |
$1K |
| 90656 |
|
82 |
82 |
$1K |
| 90670 |
|
64 |
64 |
$935.53 |
| D0274 |
Bitewings - four radiographic images |
71 |
70 |
$908.82 |
| 83655 |
|
85 |
84 |
$903.03 |
| 90734 |
|
205 |
197 |
$889.96 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
135 |
125 |
$801.61 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
25 |
24 |
$792.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
16 |
12 |
$780.33 |
| 0064A |
|
17 |
15 |
$600.00 |
| 90672 |
|
94 |
83 |
$588.19 |
| 83718 |
|
95 |
90 |
$579.31 |
| 86703 |
|
39 |
37 |
$487.06 |
| 0074A |
|
13 |
12 |
$440.00 |
| 85014 |
|
219 |
218 |
$424.32 |
| 85018 |
|
220 |
219 |
$424.00 |
| 87340 |
|
40 |
37 |
$376.96 |
| 0031A |
|
14 |
13 |
$369.07 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
39 |
38 |
$333.22 |
| 86780 |
|
26 |
24 |
$311.65 |
| 82465 |
|
95 |
90 |
$297.72 |
| 99188 |
|
28 |
27 |
$291.50 |
| 86803 |
|
38 |
38 |
$252.08 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
35 |
29 |
$243.95 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$225.50 |
| 86580 |
|
43 |
39 |
$190.40 |
| 82043 |
|
38 |
37 |
$162.27 |
| 82570 |
|
38 |
37 |
$140.11 |
| 87210 |
|
25 |
25 |
$127.52 |
| 90620 |
|
15 |
15 |
$88.23 |
| 90647 |
|
15 |
15 |
$83.45 |
| 90633 |
|
12 |
12 |
$65.57 |
| 83721 |
|
94 |
89 |
$61.13 |
| D0460 |
|
55 |
53 |
$38.80 |
| 90461 |
|
12 |
12 |
$22.71 |
| D1330 |
|
2,171 |
1,975 |
$0.00 |
| 91303 |
|
14 |
13 |
$0.00 |
| 91307 |
|
289 |
259 |
$0.00 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
61 |
55 |
$0.00 |
| D9215 |
|
37 |
25 |
$0.00 |
| 91301 |
|
245 |
241 |
$0.00 |
| 91305 |
|
185 |
169 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
19 |
18 |
$0.00 |
| 91306 |
|
17 |
15 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
12 |
12 |
$0.00 |
| 91312 |
|
148 |
145 |
$0.00 |
| 90662 |
|
18 |
17 |
$0.00 |
| 91300 |
|
2,645 |
2,317 |
$0.00 |
| D0190 |
|
963 |
816 |
$0.00 |
| D0191 |
|
123 |
123 |
$0.00 |
| 87806 |
|
33 |
31 |
$0.00 |
| 96381 |
|
16 |
16 |
$0.00 |
| D2940 |
|
16 |
13 |
$0.00 |
| D1120 |
Prophylaxis - child |
13 |
13 |
$0.00 |