| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,606 |
5,839 |
$362K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,180 |
3,914 |
$298K |
| D1110 |
Prophylaxis - adult |
2,023 |
1,950 |
$74K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,796 |
1,537 |
$39K |
| D0330 |
Panoramic radiographic image |
1,017 |
836 |
$39K |
| D0120 |
Periodic oral evaluation - established patient |
1,871 |
1,805 |
$30K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
484 |
325 |
$29K |
| 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 |
1,093 |
883 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
654 |
507 |
$13K |
| D0274 |
Bitewings - four radiographic images |
570 |
557 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
318 |
297 |
$12K |
| D7140 |
Extraction, erupted tooth or exposed root |
140 |
79 |
$10K |
| 99000 |
|
5,433 |
4,957 |
$8K |
| 36415 |
Collection of venous blood by venipuncture |
3,770 |
3,520 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
949 |
877 |
$6K |
| D0210 |
Intraoral - complete series of radiographic images |
416 |
341 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
310 |
145 |
$4K |
| 90674 |
|
124 |
120 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
612 |
575 |
$3K |
| 90686 |
|
243 |
232 |
$3K |
| 87428 |
|
69 |
67 |
$3K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
70 |
54 |
$3K |
| 81003 |
|
1,135 |
1,051 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
224 |
206 |
$2K |
| 92551 |
|
177 |
163 |
$2K |
| 99072 |
|
1,837 |
1,562 |
$1K |
| 0011A |
|
31 |
29 |
$1K |
| 0012A |
|
30 |
30 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
18 |
13 |
$503.51 |
| 99173 |
|
206 |
187 |
$448.61 |
| D0140 |
Limited oral evaluation - problem focused |
42 |
42 |
$446.94 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
28 |
26 |
$372.09 |
| 80061 |
Lipid panel |
47 |
43 |
$275.86 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
17 |
12 |
$268.41 |
| 36416 |
|
753 |
636 |
$157.32 |
| D0603 |
|
119 |
114 |
$0.00 |