| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J2315 |
Injection, naltrexone, depot form, 1 mg |
845 |
804 |
$954K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,179 |
4,760 |
$349K |
| 90837 |
Psychotherapy, 53 minutes with patient |
3,758 |
2,553 |
$315K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,257 |
5,704 |
$256K |
| D0330 |
Panoramic radiographic image |
1,878 |
1,840 |
$87K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,343 |
434 |
$80K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,441 |
1,071 |
$79K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,295 |
674 |
$72K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,408 |
2,349 |
$63K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
994 |
543 |
$52K |
| D1110 |
Prophylaxis - adult |
1,510 |
1,487 |
$51K |
| D0120 |
Periodic oral evaluation - established patient |
2,078 |
2,046 |
$35K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
518 |
333 |
$34K |
| D0274 |
Bitewings - four radiographic images |
1,405 |
1,352 |
$27K |
| 90832 |
Psychotherapy, 30 minutes with patient |
657 |
561 |
$26K |
| D1120 |
Prophylaxis - child |
1,344 |
1,327 |
$26K |
| D1206 |
Topical application of fluoride varnish |
1,662 |
1,624 |
$24K |
| 99215 |
Prolong outpt/office vis |
281 |
236 |
$23K |
| 90791 |
Psychiatric diagnostic evaluation |
146 |
143 |
$15K |
| D2335 |
|
140 |
68 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
193 |
191 |
$11K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
887 |
848 |
$11K |
| D2394 |
|
112 |
78 |
$9K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
526 |
97 |
$9K |
| D0140 |
Limited oral evaluation - problem focused |
261 |
242 |
$4K |
| 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 |
150 |
140 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
722 |
681 |
$3K |
| D2140 |
|
75 |
51 |
$3K |
| D0272 |
Bitewings - two radiographic images |
205 |
198 |
$2K |
| D2332 |
|
23 |
12 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
123 |
120 |
$2K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
34 |
27 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
241 |
120 |
$1K |
| 81025 |
|
405 |
369 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
35 |
34 |
$954.46 |
| D2951 |
|
56 |
40 |
$952.05 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
30 |
26 |
$498.75 |
| 80305 |
|
106 |
98 |
$457.38 |
| 87430 |
|
153 |
150 |
$304.75 |
| 36415 |
Collection of venous blood by venipuncture |
137 |
129 |
$280.38 |
| 90674 |
|
133 |
132 |
$265.00 |
| 97803 |
|
25 |
14 |
$234.51 |
| 82948 |
|
25 |
25 |
$79.84 |
| 36416 |
|
25 |
25 |
$25.41 |
| 81002 |
|
12 |
12 |
$21.78 |
| 90656 |
|
33 |
32 |
$15.00 |
| 3078F |
|
3,106 |
2,822 |
$0.00 |
| 4004F |
|
1,537 |
1,415 |
$0.00 |
| 3725F |
|
600 |
563 |
$0.00 |
| 99408 |
|
15 |
15 |
$0.00 |
| 3077F |
|
83 |
79 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
110 |
89 |
$0.00 |
| 1036F |
|
1,833 |
1,646 |
$0.00 |
| 3074F |
|
3,177 |
2,868 |
$0.00 |
| 3008F |
|
6,508 |
5,761 |
$0.00 |
| 3079F |
|
446 |
418 |
$0.00 |
| 3075F |
|
108 |
106 |
$0.00 |