| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,756 |
7,678 |
$429K |
| D9999 |
Unspecified adjunctive procedure, by report |
8,618 |
7,049 |
$266K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,427 |
2,868 |
$235K |
| T1015 |
Clinic visit/encounter, all-inclusive |
11,084 |
8,647 |
$218K |
| D1110 |
Prophylaxis - adult |
3,276 |
2,924 |
$145K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,262 |
741 |
$98K |
| D0120 |
Periodic oral evaluation - established patient |
4,581 |
4,104 |
$96K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,169 |
819 |
$75K |
| 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 |
2,979 |
2,401 |
$69K |
| D1206 |
Topical application of fluoride varnish |
3,320 |
2,969 |
$65K |
| D0274 |
Bitewings - four radiographic images |
1,993 |
1,780 |
$63K |
| D1120 |
Prophylaxis - child |
1,970 |
1,779 |
$61K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,551 |
1,382 |
$52K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,004 |
662 |
$49K |
| D0210 |
Intraoral - complete series of radiographic images |
950 |
845 |
$46K |
| 96158 |
|
1,897 |
1,161 |
$36K |
| D0140 |
Limited oral evaluation - problem focused |
1,035 |
900 |
$35K |
| 96156 |
|
1,490 |
1,233 |
$25K |
| D0330 |
Panoramic radiographic image |
524 |
450 |
$25K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
310 |
279 |
$16K |
| D0220 |
Intraoral - periapical first radiographic image |
1,334 |
1,153 |
$15K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
398 |
300 |
$12K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
112 |
91 |
$10K |
| 90832 |
Psychotherapy, 30 minutes with patient |
245 |
176 |
$10K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,528 |
1,370 |
$9K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
234 |
223 |
$8K |
| 90686 |
|
403 |
361 |
$5K |
| 90834 |
Psychotherapy, 45 minutes with patient |
74 |
55 |
$4K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
95 |
91 |
$4K |
| 0012A |
|
121 |
105 |
$4K |
| D0272 |
Bitewings - two radiographic images |
161 |
147 |
$3K |
| D2331 |
|
33 |
25 |
$3K |
| 0011A |
|
130 |
111 |
$3K |
| D2330 |
|
44 |
26 |
$3K |
| 96150 |
|
210 |
178 |
$2K |
| 0031A |
|
80 |
65 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
15 |
15 |
$2K |
| 90674 |
|
107 |
72 |
$1K |
| 90688 |
|
86 |
79 |
$1K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
13 |
13 |
$1K |
| 90656 |
|
70 |
66 |
$839.33 |
| 0064A |
|
27 |
24 |
$818.62 |
| D1208 |
Topical application of fluoride, excluding varnish |
17 |
17 |
$291.07 |
| 96152 |
|
14 |
12 |
$139.40 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
91 |
86 |
$0.00 |