| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,820 |
11,034 |
$2.19M |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,556 |
2,484 |
$406K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,431 |
1,328 |
$247K |
| D1120 |
Prophylaxis - child |
1,465 |
1,440 |
$239K |
| D1206 |
Topical application of fluoride varnish |
2,676 |
2,622 |
$204K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,433 |
1,125 |
$182K |
| 90837 |
Psychotherapy, 53 minutes with patient |
765 |
586 |
$134K |
| D1110 |
Prophylaxis - adult |
271 |
270 |
$51K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
165 |
161 |
$32K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
142 |
140 |
$27K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
212 |
212 |
$26K |
| D0330 |
Panoramic radiographic image |
117 |
115 |
$21K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
228 |
60 |
$20K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
93 |
88 |
$18K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
515 |
496 |
$18K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
78 |
49 |
$13K |
| D1351 |
Sealant - per tooth |
1,237 |
279 |
$11K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
40 |
39 |
$8K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
118 |
113 |
$7K |
| D0274 |
Bitewings - four radiographic images |
139 |
139 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
41 |
40 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
33 |
29 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
27 |
$4K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
273 |
262 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
198 |
187 |
$3K |
| D7140 |
Extraction, erupted tooth or exposed root |
61 |
27 |
$3K |
| 99384 |
|
18 |
18 |
$3K |
| 99173 |
|
407 |
396 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
1,108 |
1,092 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
16 |
12 |
$2K |
| 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 |
1,269 |
1,029 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
656 |
637 |
$2K |
| D0272 |
Bitewings - two radiographic images |
736 |
716 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
63 |
63 |
$766.71 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
15 |
15 |
$499.85 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
126 |
116 |
$479.75 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
686 |
647 |
$197.09 |
| 90686 |
|
225 |
205 |
$166.33 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
24 |
24 |
$129.49 |
| D0230 |
Intraoral - periapical each additional radiographic image |
601 |
320 |
$34.35 |
| 36415 |
Collection of venous blood by venipuncture |
795 |
758 |
$14.16 |
| D1330 |
|
62 |
62 |
$0.00 |
| D0603 |
|
956 |
943 |
$0.00 |
| 0001A |
|
20 |
17 |
$0.00 |
| 3079F |
|
53 |
51 |
$0.00 |
| 3075F |
|
33 |
30 |
$0.00 |
| 90651 |
|
61 |
61 |
$0.00 |
| 94760 |
|
61 |
47 |
$0.00 |
| 90619 |
|
13 |
13 |
$0.00 |
| 90656 |
|
15 |
15 |
$0.00 |
| D0191 |
|
49 |
48 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| 3078F |
|
84 |
76 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
159 |
154 |
$0.00 |
| 0002A |
|
19 |
19 |
$0.00 |
| 90734 |
|
47 |
44 |
$0.00 |