| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
83,103 |
49,896 |
$33.67M |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
8,854 |
5,072 |
$568K |
| 96153 |
|
7,746 |
1,758 |
$559K |
| 96165 |
|
8,916 |
2,429 |
$502K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,803 |
7,944 |
$386K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,727 |
3,919 |
$262K |
| 96164 |
|
8,928 |
2,434 |
$155K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,215 |
2,612 |
$82K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,338 |
1,213 |
$80K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,080 |
584 |
$78K |
| D0120 |
Periodic oral evaluation - established patient |
3,081 |
3,003 |
$71K |
| H0001 |
Alcohol and/or drug assessment |
469 |
437 |
$48K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,799 |
1,510 |
$46K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
664 |
487 |
$40K |
| D1206 |
Topical application of fluoride varnish |
2,535 |
2,345 |
$38K |
| 90834 |
Psychotherapy, 45 minutes with patient |
615 |
380 |
$30K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,522 |
2,222 |
$30K |
| D1110 |
Prophylaxis - adult |
1,166 |
1,134 |
$28K |
| 90832 |
Psychotherapy, 30 minutes with patient |
596 |
275 |
$27K |
| D1120 |
Prophylaxis - child |
1,212 |
1,191 |
$26K |
| 92015 |
Determination of refractive state |
2,256 |
2,067 |
$20K |
| D0220 |
Intraoral - periapical first radiographic image |
2,543 |
2,441 |
$20K |
| D0140 |
Limited oral evaluation - problem focused |
771 |
723 |
$17K |
| 90791 |
Psychiatric diagnostic evaluation |
184 |
172 |
$15K |
| D1351 |
Sealant - per tooth |
998 |
251 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,706 |
1,456 |
$8K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
285 |
246 |
$7K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
120 |
92 |
$6K |
| 90658 |
|
357 |
304 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
141 |
139 |
$6K |
| D1999 |
|
676 |
560 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,401 |
1,109 |
$5K |
| 0124A |
|
131 |
128 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
60 |
53 |
$4K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
292 |
121 |
$3K |
| D0330 |
Panoramic radiographic image |
104 |
103 |
$3K |
| D0274 |
Bitewings - four radiographic images |
234 |
227 |
$3K |
| 0002A |
|
165 |
138 |
$2K |
| 99215 |
Prolong outpt/office vis |
31 |
25 |
$2K |
| 0001A |
|
192 |
160 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
15 |
$1K |
| 0004A |
|
42 |
31 |
$1K |
| D4910 |
|
24 |
24 |
$1K |
| 0154A |
|
30 |
27 |
$1K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
14 |
14 |
$796.96 |
| 0012A |
|
34 |
33 |
$600.98 |
| 83655 |
|
56 |
44 |
$547.70 |
| 36415 |
Collection of venous blood by venipuncture |
203 |
175 |
$432.99 |
| 90651 |
|
13 |
12 |
$280.69 |
| 90655 |
|
82 |
72 |
$164.00 |
| D0272 |
Bitewings - two radiographic images |
15 |
15 |
$154.35 |
| 90686 |
|
33 |
31 |
$152.47 |
| 92551 |
|
86 |
70 |
$117.56 |
| 0011A |
|
12 |
12 |
$116.40 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
111 |
101 |
$85.37 |
| 83721 |
|
12 |
12 |
$76.96 |
| 36416 |
|
34 |
25 |
$51.27 |
| 80061 |
Lipid panel |
12 |
12 |
$36.81 |
| 82962 |
|
15 |
13 |
$28.42 |
| 99173 |
|
67 |
54 |
$25.48 |
| 91300 |
|
573 |
475 |
$0.00 |
| D0180 |
|
55 |
55 |
$0.00 |
| D0190 |
|
38 |
38 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
20 |
20 |
$0.00 |
| 91312 |
|
165 |
156 |
$0.00 |
| D0277 |
|
31 |
30 |
$0.00 |
| 91308 |
|
13 |
12 |
$0.00 |
| D2940 |
|
19 |
13 |
$0.00 |
| D9215 |
|
3,420 |
2,873 |
$0.00 |
| D1330 |
|
4,269 |
3,663 |
$0.00 |
| 91307 |
|
59 |
58 |
$0.00 |
| 91315 |
|
13 |
13 |
$0.00 |
| 91301 |
|
67 |
63 |
$0.00 |