| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
42,700 |
29,149 |
$3.70M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,541 |
4,591 |
$69K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,563 |
3,157 |
$60K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,240 |
2,038 |
$45K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,557 |
1,309 |
$28K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
3,230 |
1,906 |
$26K |
| 99441 |
|
5,066 |
3,523 |
$22K |
| D1110 |
Prophylaxis - adult |
2,642 |
1,938 |
$20K |
| D0330 |
Panoramic radiographic image |
1,197 |
852 |
$20K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,716 |
1,113 |
$18K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,886 |
1,194 |
$18K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
6,891 |
4,661 |
$18K |
| 90837 |
Psychotherapy, 53 minutes with patient |
401 |
235 |
$11K |
| D0120 |
Periodic oral evaluation - established patient |
1,671 |
1,211 |
$10K |
| 90791 |
Psychiatric diagnostic evaluation |
561 |
369 |
$8K |
| D1206 |
Topical application of fluoride varnish |
1,714 |
1,284 |
$8K |
| D1120 |
Prophylaxis - child |
1,407 |
1,050 |
$7K |
| D0210 |
Intraoral - complete series of radiographic images |
3,122 |
2,126 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
475 |
380 |
$6K |
| D0274 |
Bitewings - four radiographic images |
3,072 |
2,147 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
1,472 |
935 |
$6K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
590 |
490 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
1,245 |
806 |
$1K |
| D2331 |
|
20 |
12 |
$1K |
| 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 |
88 |
78 |
$1K |
| T2003 |
Non-emergency transportation; encounter/trip |
557 |
293 |
$755.56 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
114 |
79 |
$700.74 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
25 |
14 |
$528.42 |
| 99442 |
|
15 |
13 |
$137.58 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
32 |
25 |
$68.25 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
20 |
17 |
$57.76 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
33 |
26 |
$36.40 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
73 |
56 |
$35.33 |
| 3074F |
|
1,199 |
828 |
$0.07 |
| 3077F |
|
149 |
117 |
$0.05 |
| 3078F |
|
945 |
625 |
$0.05 |
| 3080F |
|
55 |
41 |
$0.05 |
| 3079F |
|
728 |
519 |
$0.03 |
| 1160F |
|
3,334 |
2,289 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
14 |
$0.00 |
| D0603 |
|
419 |
320 |
$0.00 |
| 3075F |
|
205 |
125 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
137 |
100 |
$0.00 |
| D2330 |
|
159 |
95 |
$0.00 |
| D0602 |
|
41 |
36 |
$0.00 |
| D0601 |
|
35 |
14 |
$0.00 |