| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
159,637 |
116,666 |
$10.79M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
133,106 |
68,354 |
$2.66M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
46,296 |
25,965 |
$1.43M |
| D7140 |
Extraction, erupted tooth or exposed root |
11,374 |
5,070 |
$492K |
| D0330 |
Panoramic radiographic image |
15,366 |
11,432 |
$456K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
32,771 |
13,184 |
$436K |
| 90791 |
Psychiatric diagnostic evaluation |
8,224 |
4,336 |
$367K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
18,454 |
13,108 |
$312K |
| D1351 |
Sealant - per tooth |
11,855 |
2,606 |
$230K |
| D1120 |
Prophylaxis - child |
13,470 |
9,915 |
$197K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
6,789 |
3,773 |
$192K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
5,794 |
3,001 |
$191K |
| D1110 |
Prophylaxis - adult |
9,209 |
6,226 |
$191K |
| D0140 |
Limited oral evaluation - problem focused |
14,300 |
8,931 |
$167K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13,217 |
7,417 |
$165K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
5,372 |
2,846 |
$165K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,744 |
3,241 |
$138K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,907 |
2,663 |
$134K |
| D1208 |
Topical application of fluoride, excluding varnish |
13,461 |
10,023 |
$131K |
| D0120 |
Periodic oral evaluation - established patient |
10,734 |
7,544 |
$118K |
| D1206 |
Topical application of fluoride varnish |
6,570 |
4,654 |
$94K |
| D0274 |
Bitewings - four radiographic images |
9,295 |
6,517 |
$76K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,072 |
1,143 |
$63K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,191 |
1,257 |
$49K |
| 99051 |
|
3,827 |
2,041 |
$40K |
| D0220 |
Intraoral - periapical first radiographic image |
13,247 |
8,066 |
$37K |
| 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 |
3,983 |
3,379 |
$36K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,911 |
914 |
$34K |
| D0272 |
Bitewings - two radiographic images |
5,578 |
4,121 |
$34K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
722 |
394 |
$32K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
703 |
400 |
$25K |
| 92551 |
|
6,910 |
3,754 |
$21K |
| 99215 |
Prolong outpt/office vis |
385 |
184 |
$17K |
| D0210 |
Intraoral - complete series of radiographic images |
758 |
616 |
$14K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,996 |
1,130 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,323 |
1,244 |
$11K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
840 |
648 |
$10K |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,643 |
1,469 |
$9K |
| D0250 |
|
692 |
628 |
$9K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
309 |
277 |
$8K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
537 |
341 |
$8K |
| 90670 |
|
4,055 |
2,464 |
$6K |
| 99381 |
|
208 |
140 |
$4K |
| D2330 |
|
155 |
95 |
$4K |
| D1354 |
|
164 |
62 |
$4K |
| D2331 |
|
68 |
42 |
$4K |
| 99383 |
|
222 |
149 |
$4K |
| 99348 |
|
216 |
79 |
$4K |
| 90710 |
|
2,317 |
1,367 |
$4K |
| 92552 |
|
681 |
423 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
386 |
232 |
$4K |
| 99347 |
|
256 |
97 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
928 |
616 |
$3K |
| 92015 |
Determination of refractive state |
240 |
222 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
158 |
111 |
$3K |
| 99342 |
|
136 |
75 |
$2K |
| 99382 |
|
136 |
112 |
$2K |
| 99173 |
|
1,703 |
1,095 |
$2K |
| 90671 |
|
706 |
417 |
$2K |
| 90661 |
|
346 |
325 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
58 |
52 |
$2K |
| 99354 |
|
69 |
43 |
$2K |
| 90658 |
|
620 |
343 |
$2K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
23 |
12 |
$1K |
| 90656 |
|
593 |
363 |
$1K |
| 90674 |
|
519 |
277 |
$1K |
| 90723 |
|
3,505 |
2,110 |
$1K |
| 90633 |
|
3,124 |
1,887 |
$1K |
| 99384 |
|
65 |
39 |
$1K |
| D2332 |
|
16 |
13 |
$1K |
| 20610 |
|
76 |
38 |
$1K |
| 90651 |
|
1,114 |
629 |
$1K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
18 |
12 |
$918.00 |
| 81025 |
|
216 |
174 |
$761.46 |
| 80305 |
|
165 |
87 |
$712.16 |
| 0012A |
|
19 |
18 |
$652.50 |
| 90746 |
|
20 |
13 |
$633.42 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$607.75 |
| V2020 |
Frames, purchases |
82 |
63 |
$570.00 |
| D0270 |
|
190 |
170 |
$545.00 |
| 0011A |
|
31 |
25 |
$530.24 |
| 90647 |
|
3,538 |
2,128 |
$530.22 |
| 90686 |
|
1,232 |
690 |
$514.63 |
| 81003 |
|
574 |
409 |
$422.01 |
| 81002 |
|
381 |
240 |
$377.09 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13 |
12 |
$330.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
29 |
24 |
$288.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
61 |
27 |
$262.04 |
| 90734 |
|
829 |
450 |
$253.50 |
| 90685 |
|
950 |
556 |
$247.29 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
34 |
32 |
$243.68 |
| 36416 |
|
144 |
83 |
$225.86 |
| 99406 |
|
37 |
21 |
$154.51 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
89 |
49 |
$118.52 |
| 90715 |
|
357 |
204 |
$109.73 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
40 |
18 |
$64.00 |
| 3044F |
|
2,501 |
1,426 |
$60.00 |
| 90696 |
|
345 |
186 |
$57.26 |
| 90681 |
|
1,474 |
891 |
$38.04 |
| 85018 |
|
27 |
13 |
$21.36 |
| 90700 |
|
430 |
250 |
$10.79 |
| 91301 |
|
50 |
27 |
$0.24 |
| 90687 |
|
1,074 |
649 |
$0.14 |
| 90657 |
|
75 |
47 |
$0.04 |
| 90620 |
|
50 |
26 |
$0.03 |
| 90707 |
|
30 |
17 |
$0.01 |
| 3078F |
|
59,600 |
37,142 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
74,334 |
43,423 |
$0.00 |
| 3077F |
|
19,488 |
11,732 |
$0.00 |
| 4004F |
|
12,588 |
8,215 |
$0.00 |
| 3051F |
|
111 |
45 |
$0.00 |
| 3046F |
|
1,871 |
975 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
17,474 |
10,205 |
$0.00 |
| 3045F |
|
112 |
97 |
$0.00 |
| 1159F |
|
434 |
227 |
$0.00 |
| D0190 |
|
29 |
28 |
$0.00 |
| 86328 |
|
189 |
120 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
36 |
29 |
$0.00 |
| S9529 |
Routine venipuncture for collection of specimen(s), single home bound, nursing home, or skilled nursing facility patient |
120 |
62 |
$0.00 |
| 2001F |
|
107,042 |
62,777 |
$0.00 |
| 3074F |
|
68,886 |
42,353 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
14,067 |
8,146 |
$0.00 |
| 3075F |
|
15,579 |
9,413 |
$0.00 |
| 1036F |
|
64,083 |
38,558 |
$0.00 |
| 3079F |
|
31,308 |
18,640 |
$0.00 |
| 3008F |
|
106,903 |
62,774 |
$0.00 |
| D0603 |
|
88 |
67 |
$0.00 |
| 3080F |
|
12,795 |
7,653 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
77,786 |
45,449 |
$0.00 |
| 3048F |
|
591 |
341 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
405 |
350 |
$0.00 |
| 90697 |
|
254 |
152 |
$0.00 |
| 99172 |
|
18 |
13 |
$0.00 |