| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
22,890 |
14,845 |
$2.34M |
| D0999 |
Unspecified diagnostic procedure, by report |
17,704 |
12,765 |
$1.49M |
| H2020 |
Therapeutic behavioral services, per diem |
4,123 |
1,526 |
$166K |
| D7140 |
Extraction, erupted tooth or exposed root |
10,801 |
4,228 |
$125K |
| D0330 |
Panoramic radiographic image |
4,819 |
3,671 |
$41K |
| D1110 |
Prophylaxis - adult |
5,138 |
3,966 |
$31K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,008 |
3,097 |
$24K |
| D0274 |
Bitewings - four radiographic images |
3,967 |
2,960 |
$12K |
| D0140 |
Limited oral evaluation - problem focused |
4,036 |
3,031 |
$8K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
838 |
551 |
$7K |
| D0120 |
Periodic oral evaluation - established patient |
2,530 |
2,081 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,795 |
8,240 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
1,608 |
1,137 |
$5K |
| D2335 |
|
26 |
13 |
$2K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
309 |
224 |
$1K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
127 |
82 |
$979.98 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,549 |
3,513 |
$385.14 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,337 |
1,621 |
$75.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,269 |
1,593 |
$63.55 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
256 |
149 |
$52.50 |
| D0272 |
Bitewings - two radiographic images |
201 |
191 |
$21.43 |
| 36415 |
Collection of venous blood by venipuncture |
1,159 |
935 |
$16.04 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
407 |
221 |
$1.04 |
| 1101F |
|
1,008 |
787 |
$0.00 |
| 3008F |
|
2,633 |
1,811 |
$0.00 |
| 96127 |
|
2,444 |
1,012 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
1,634 |
1,296 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
311 |
305 |
$0.00 |
| 3074F |
|
1,052 |
839 |
$0.00 |
| 1126F |
|
681 |
540 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
186 |
111 |
$0.00 |
| 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 |
70 |
56 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
876 |
339 |
$0.00 |
| 1170F |
|
1,442 |
1,155 |
$0.00 |
| 99406 |
|
33 |
24 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
415 |
261 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
45 |
37 |
$0.00 |
| 3079F |
|
175 |
158 |
$0.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
121 |
84 |
$0.00 |
| D0601 |
|
87 |
75 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
38 |
12 |
$0.00 |
| 87807 |
|
13 |
12 |
$0.00 |
| 3075F |
|
15 |
14 |
$0.00 |
| 1125F |
|
25 |
25 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
13 |
12 |
$0.00 |
| D0603 |
|
19 |
19 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
18 |
18 |
$0.00 |
| 3080F |
|
18 |
14 |
$0.00 |
| 1159F |
|
2,745 |
1,890 |
$0.00 |
| 3078F |
|
889 |
675 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
606 |
281 |
$0.00 |
| D1120 |
Prophylaxis - child |
1,079 |
1,007 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
630 |
244 |
$0.00 |
| 1160F |
|
1,179 |
917 |
$0.00 |
| 3288F |
|
1,540 |
1,060 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
383 |
277 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
263 |
52 |
$0.00 |
| 99173 |
|
114 |
96 |
$0.00 |
| 81025 |
|
131 |
107 |
$0.00 |
| D1999 |
|
85 |
81 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
56 |
49 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
14 |
$0.00 |
| 81003 |
|
247 |
172 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
32 |
30 |
$0.00 |
| 11721 |
|
15 |
13 |
$0.00 |
| 3077F |
|
22 |
17 |
$0.00 |
| 90682 |
|
12 |
12 |
$0.00 |