| Code | Description | Claims | Beneficiaries | Total Paid |
| D1120 |
Prophylaxis - child |
45,317 |
11,486 |
$2.30M |
| D1330 |
|
32,244 |
8,792 |
$1.62M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,907 |
11,703 |
$1.29M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
55,137 |
31,772 |
$1.02M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21,781 |
7,753 |
$783K |
| D1206 |
Topical application of fluoride varnish |
14,606 |
4,766 |
$745K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
10,950 |
3,736 |
$550K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
7,559 |
1,393 |
$543K |
| D0120 |
Periodic oral evaluation - established patient |
9,767 |
6,326 |
$349K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,995 |
1,853 |
$224K |
| D0190 |
|
5,262 |
2,374 |
$221K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
3,562 |
3,129 |
$195K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
30,272 |
16,504 |
$193K |
| D1110 |
Prophylaxis - adult |
5,195 |
3,943 |
$176K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,219 |
780 |
$160K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,486 |
1,418 |
$154K |
| 99401 |
|
4,909 |
4,151 |
$151K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,760 |
1,750 |
$117K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
6,668 |
5,893 |
$116K |
| 10040 |
|
643 |
490 |
$97K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
707 |
705 |
$78K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,030 |
261 |
$74K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
819 |
586 |
$72K |
| D0274 |
Bitewings - four radiographic images |
4,210 |
4,069 |
$71K |
| 92060 |
|
2,681 |
629 |
$69K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
604 |
603 |
$69K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
591 |
582 |
$63K |
| 17360 |
|
711 |
538 |
$62K |
| T1017 |
Targeted case management, each 15 minutes |
2,868 |
1,329 |
$59K |
| 99441 |
|
357 |
350 |
$43K |
| 86328 |
|
1,025 |
984 |
$38K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
246 |
240 |
$30K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
2,345 |
2,010 |
$28K |
| D0330 |
Panoramic radiographic image |
996 |
713 |
$27K |
| 11900 |
|
104 |
90 |
$23K |
| 97129 |
|
258 |
92 |
$18K |
| 92551 |
|
260 |
260 |
$17K |
| 92557 |
|
854 |
477 |
$17K |
| 11901 |
|
76 |
52 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
300 |
181 |
$12K |
| D1351 |
Sealant - per tooth |
311 |
55 |
$11K |
| 99385 |
|
140 |
140 |
$11K |
| 11720 |
|
431 |
82 |
$11K |
| 36415 |
Collection of venous blood by venipuncture |
3,205 |
3,114 |
$10K |
| 92201 |
|
111 |
111 |
$10K |
| 11721 |
|
1,429 |
274 |
$10K |
| D0140 |
Limited oral evaluation - problem focused |
737 |
683 |
$10K |
| D0210 |
Intraoral - complete series of radiographic images |
550 |
546 |
$9K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
129 |
50 |
$9K |
| D0220 |
Intraoral - periapical first radiographic image |
976 |
932 |
$9K |
| 97116 |
|
110 |
43 |
$8K |
| D9920 |
|
152 |
31 |
$8K |
| 96112 |
|
21 |
12 |
$7K |
| 97130 |
|
89 |
38 |
$6K |
| 99173 |
|
277 |
274 |
$6K |
| 90630 |
|
264 |
264 |
$6K |
| 99215 |
Prolong outpt/office vis |
52 |
51 |
$5K |
| 90682 |
|
260 |
260 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
276 |
265 |
$5K |
| 90686 |
|
226 |
226 |
$4K |
| D4910 |
|
31 |
26 |
$4K |
| 90832 |
Psychotherapy, 30 minutes with patient |
41 |
37 |
$4K |
| 99442 |
|
34 |
29 |
$4K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
81 |
81 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
672 |
639 |
$3K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
87 |
87 |
$3K |
| 96160 |
|
54 |
54 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,307 |
1,278 |
$3K |
| 92020 |
|
30 |
30 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
16 |
12 |
$2K |
| 99386 |
|
40 |
40 |
$2K |
| 90715 |
|
104 |
104 |
$2K |
| 92133 |
|
46 |
46 |
$2K |
| 76512 |
|
277 |
146 |
$2K |
| 99050 |
|
297 |
279 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
43 |
37 |
$2K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
12 |
12 |
$1K |
| 99490 |
Ccm add 20min |
13 |
13 |
$850.57 |
| 1111F |
|
9,797 |
7,900 |
$832.33 |
| 92083 |
|
26 |
26 |
$803.56 |
| 92250 |
|
26 |
26 |
$803.56 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$754.68 |
| 99406 |
|
17 |
14 |
$596.89 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
87 |
74 |
$563.58 |
| G0008 |
Administration of influenza virus vaccine |
51 |
51 |
$562.06 |
| 90649 |
|
13 |
13 |
$558.94 |
| D4341 |
|
34 |
12 |
$514.18 |
| 93000 |
|
1,276 |
1,259 |
$509.64 |
| 96127 |
|
537 |
486 |
$454.84 |
| 92134 |
|
14 |
12 |
$393.41 |
| 90656 |
|
38 |
38 |
$363.09 |
| 0011A |
|
13 |
13 |
$359.94 |
| 99497 |
|
35 |
30 |
$323.50 |
| 0012A |
|
20 |
20 |
$303.34 |
| 92015 |
Determination of refractive state |
18 |
16 |
$251.07 |
| 92226 |
|
201 |
106 |
$240.53 |
| 81003 |
|
1,573 |
1,552 |
$215.75 |
| 82962 |
|
1,271 |
1,120 |
$161.01 |
| 99051 |
|
12 |
12 |
$152.28 |
| 90633 |
|
13 |
13 |
$149.93 |
| D0230 |
Intraoral - periapical each additional radiographic image |
16 |
16 |
$128.47 |
| 90461 |
|
36 |
34 |
$99.77 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
12 |
$45.87 |
| 3078F |
|
6,683 |
5,608 |
$41.17 |
| 3074F |
|
7,351 |
6,090 |
$37.02 |
| 81025 |
|
40 |
39 |
$26.31 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
595 |
443 |
$17.69 |
| 94760 |
|
179 |
165 |
$2.70 |
| 81002 |
|
90 |
90 |
$2.00 |
| 1159F |
|
10,896 |
8,697 |
$2.00 |
| 1157F |
|
3,463 |
3,051 |
$1.01 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
202 |
188 |
$0.15 |
| 3077F |
|
2,093 |
1,831 |
$0.00 |
| 1160F |
|
3,389 |
2,985 |
$0.00 |
| 0521F |
|
1,150 |
1,049 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
18 |
18 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
201 |
183 |
$0.00 |
| 99080 |
|
38 |
15 |
$0.00 |
| 99072 |
|
29 |
27 |
$0.00 |
| 1126F |
|
10,563 |
8,566 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
14,182 |
11,659 |
$0.00 |
| 1170F |
|
2,752 |
2,404 |
$0.00 |
| 1125F |
|
1,161 |
1,050 |
$0.00 |
| 3075F |
|
2,213 |
2,004 |
$0.00 |
| 3008F |
|
253 |
240 |
$0.00 |
| 3080F |
|
1,292 |
1,124 |
$0.00 |
| 3079F |
|
3,730 |
3,288 |
$0.00 |
| 91301 |
|
20 |
17 |
$0.00 |
| 3044F |
|
12 |
12 |
$0.00 |
| 94761 |
|
23 |
21 |
$0.00 |