| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
23,250 |
20,221 |
$5.66M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19,830 |
17,221 |
$3.04M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,940 |
2,639 |
$304K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,335 |
1,210 |
$195K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
756 |
736 |
$126K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
672 |
666 |
$120K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,634 |
4,545 |
$102K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
286 |
277 |
$42K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
228 |
225 |
$34K |
| D1351 |
Sealant - per tooth |
2,989 |
1,026 |
$32K |
| D1110 |
Prophylaxis - adult |
1,342 |
1,324 |
$31K |
| D1120 |
Prophylaxis - child |
1,559 |
1,526 |
$29K |
| D0220 |
Intraoral - periapical first radiographic image |
3,493 |
3,384 |
$26K |
| 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 |
1,088 |
913 |
$25K |
| D0120 |
Periodic oral evaluation - established patient |
1,578 |
1,546 |
$23K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
728 |
709 |
$19K |
| D1354 |
|
1,375 |
483 |
$18K |
| D0274 |
Bitewings - four radiographic images |
999 |
975 |
$17K |
| D0350 |
|
752 |
740 |
$15K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
71 |
66 |
$13K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
83 |
29 |
$12K |
| D7140 |
Extraction, erupted tooth or exposed root |
152 |
89 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
51 |
49 |
$9K |
| D0190 |
|
2,385 |
2,376 |
$9K |
| 99382 |
|
42 |
42 |
$8K |
| 99000 |
|
2,008 |
1,917 |
$8K |
| 90461 |
|
739 |
736 |
$8K |
| D0145 |
Oral evaluation for a patient under three years of age |
326 |
322 |
$7K |
| 90686 |
|
243 |
242 |
$7K |
| D0330 |
Panoramic radiographic image |
247 |
237 |
$6K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
142 |
121 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
169 |
166 |
$6K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,902 |
1,855 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
31 |
31 |
$5K |
| 0012A |
|
129 |
128 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
275 |
268 |
$4K |
| D0272 |
Bitewings - two radiographic images |
477 |
454 |
$4K |
| 0001A |
|
103 |
97 |
$4K |
| 0002A |
|
100 |
90 |
$3K |
| 0011A |
|
102 |
102 |
$3K |
| D1206 |
Topical application of fluoride varnish |
9,425 |
9,024 |
$3K |
| 0064A |
|
88 |
81 |
$3K |
| D1353 |
|
223 |
134 |
$2K |
| 0071A |
|
66 |
63 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
145 |
125 |
$2K |
| 0072A |
|
64 |
62 |
$2K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
464 |
406 |
$667.86 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
13 |
12 |
$650.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
99 |
83 |
$408.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
29 |
23 |
$400.86 |
| 36415 |
Collection of venous blood by venipuncture |
2,874 |
2,770 |
$234.63 |
| D0270 |
|
12 |
12 |
$132.00 |
| 85018 |
|
84 |
83 |
$1.66 |
| 36416 |
|
144 |
141 |
$0.00 |
| 81003 |
|
743 |
572 |
$0.00 |
| 81025 |
|
19 |
17 |
$0.00 |
| D9996 |
|
275 |
272 |
$0.00 |