| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
14,765 |
11,682 |
$5.32M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,720 |
4,638 |
$928K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,046 |
3,034 |
$499K |
| 90834 |
Psychotherapy, 45 minutes with patient |
997 |
473 |
$196K |
| D7140 |
Extraction, erupted tooth or exposed root |
770 |
369 |
$71K |
| 90837 |
Psychotherapy, 53 minutes with patient |
302 |
160 |
$57K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
249 |
221 |
$41K |
| D0330 |
Panoramic radiographic image |
895 |
799 |
$33K |
| D0274 |
Bitewings - four radiographic images |
1,514 |
1,297 |
$30K |
| D1110 |
Prophylaxis - adult |
961 |
824 |
$29K |
| D0140 |
Limited oral evaluation - problem focused |
1,248 |
1,131 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
160 |
146 |
$25K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
303 |
225 |
$25K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,048 |
900 |
$24K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
79 |
76 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
128 |
110 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
180 |
165 |
$14K |
| D0120 |
Periodic oral evaluation - established patient |
593 |
521 |
$12K |
| 90832 |
Psychotherapy, 30 minutes with patient |
59 |
25 |
$9K |
| 99000 |
|
1,293 |
1,161 |
$7K |
| 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 |
896 |
598 |
$7K |
| D0220 |
Intraoral - periapical first radiographic image |
610 |
564 |
$5K |
| D1206 |
Topical application of fluoride varnish |
142 |
115 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
97 |
64 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
809 |
696 |
$4K |
| D0391 |
|
25 |
25 |
$4K |
| 0002A |
|
112 |
66 |
$3K |
| 0012A |
|
92 |
87 |
$3K |
| H0031 |
Mental health assessment, by non-physician |
13 |
12 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
15 |
14 |
$3K |
| 0001A |
|
78 |
63 |
$3K |
| 0011A |
|
63 |
61 |
$2K |
| 90656 |
|
99 |
98 |
$1K |
| D1120 |
Prophylaxis - child |
12 |
12 |
$828.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,256 |
1,123 |
$807.29 |
| 90686 |
|
403 |
392 |
$700.74 |
| 90651 |
|
44 |
35 |
$261.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,223 |
604 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,497 |
1,251 |
$0.00 |
| 3078F |
|
73 |
67 |
$0.00 |
| 99173 |
|
91 |
90 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
237 |
203 |
$0.00 |
| 90670 |
|
27 |
24 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$0.00 |
| 1159F |
|
16 |
16 |
$0.00 |
| 90734 |
|
20 |
14 |
$0.00 |
| 90710 |
|
16 |
13 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,501 |
1,440 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
491 |
437 |
$0.00 |
| 96127 |
|
14 |
12 |
$0.00 |
| 90688 |
|
58 |
58 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
341 |
262 |
$0.00 |
| 87807 |
|
85 |
72 |
$0.00 |
| 85018 |
|
24 |
24 |
$0.00 |
| 3074F |
|
76 |
69 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
30 |
25 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
32 |
29 |
$0.00 |