| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
47,055 |
36,129 |
$3.42M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
39,026 |
21,086 |
$819K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,103 |
4,866 |
$278K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
19,241 |
7,520 |
$231K |
| 90832 |
Psychotherapy, 30 minutes with patient |
7,111 |
2,930 |
$144K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,258 |
1,790 |
$87K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,219 |
1,858 |
$74K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
885 |
864 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,658 |
897 |
$22K |
| D1120 |
Prophylaxis - child |
834 |
818 |
$15K |
| D1110 |
Prophylaxis - adult |
556 |
540 |
$15K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
270 |
177 |
$14K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
310 |
171 |
$14K |
| D1206 |
Topical application of fluoride varnish |
1,015 |
972 |
$14K |
| D0120 |
Periodic oral evaluation - established patient |
821 |
781 |
$14K |
| D7140 |
Extraction, erupted tooth or exposed root |
230 |
141 |
$13K |
| 99382 |
|
437 |
379 |
$13K |
| D0140 |
Limited oral evaluation - problem focused |
615 |
584 |
$12K |
| D0330 |
Panoramic radiographic image |
266 |
261 |
$11K |
| 99383 |
|
383 |
328 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
369 |
201 |
$11K |
| 90834 |
Psychotherapy, 45 minutes with patient |
303 |
169 |
$8K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
163 |
85 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
241 |
130 |
$7K |
| 97803 |
|
284 |
144 |
$6K |
| D0210 |
Intraoral - complete series of radiographic images |
94 |
93 |
$5K |
| 96152 |
|
704 |
381 |
$5K |
| 90791 |
Psychiatric diagnostic evaluation |
96 |
50 |
$5K |
| 99381 |
|
287 |
229 |
$5K |
| D1351 |
Sealant - per tooth |
195 |
56 |
$4K |
| D0274 |
Bitewings - four radiographic images |
330 |
324 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
169 |
132 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
405 |
198 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
41 |
26 |
$2K |
| 90686 |
|
3,196 |
1,752 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
266 |
138 |
$2K |
| 97802 |
|
47 |
24 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
74 |
40 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
319 |
299 |
$1K |
| D2140 |
|
38 |
25 |
$1K |
| 99384 |
|
34 |
34 |
$957.84 |
| 99441 |
|
186 |
91 |
$938.56 |
| 85018 |
|
931 |
523 |
$931.41 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
54 |
37 |
$875.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
22 |
12 |
$693.33 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
83 |
41 |
$653.45 |
| 96127 |
|
290 |
154 |
$590.85 |
| D1208 |
Topical application of fluoride, excluding varnish |
40 |
40 |
$570.00 |
| D0272 |
Bitewings - two radiographic images |
101 |
98 |
$560.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
168 |
94 |
$552.43 |
| 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 |
46 |
45 |
$493.56 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
92 |
60 |
$365.96 |
| 3078F |
|
2,320 |
1,337 |
$313.00 |
| 90656 |
|
51 |
46 |
$312.94 |
| 3074F |
|
2,608 |
1,537 |
$300.00 |
| 3008F |
|
3,572 |
1,923 |
$244.00 |
| 80305 |
|
39 |
25 |
$234.60 |
| D0350 |
|
17 |
16 |
$196.96 |
| 3079F |
|
410 |
210 |
$123.00 |
| 81025 |
|
30 |
13 |
$90.76 |
| 36416 |
|
101 |
49 |
$32.85 |
| 96156 |
|
47 |
34 |
$24.23 |
| 90670 |
|
2,824 |
1,737 |
$3.28 |
| 90633 |
|
1,308 |
855 |
$2.83 |
| 90698 |
|
1,670 |
1,028 |
$1.04 |
| 90680 |
|
778 |
508 |
$0.53 |
| 90744 |
|
596 |
394 |
$0.29 |
| 90685 |
|
240 |
160 |
$0.10 |
| 90651 |
|
155 |
85 |
$0.02 |
| 90648 |
|
98 |
82 |
$0.02 |
| 90716 |
|
53 |
40 |
$0.01 |
| 90707 |
|
112 |
76 |
$0.01 |
| 90710 |
|
51 |
28 |
$0.01 |
| 90700 |
|
49 |
28 |
$0.01 |
| D1330 |
|
279 |
228 |
$0.00 |
| 1036F |
|
495 |
447 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
32 |
30 |
$0.00 |
| 90696 |
|
48 |
25 |
$0.00 |
| 3075F |
|
46 |
24 |
$0.00 |
| 90697 |
|
26 |
14 |
$0.00 |
| 90723 |
|
16 |
15 |
$0.00 |
| D0603 |
|
12 |
12 |
$0.00 |
| 90734 |
|
55 |
28 |
$0.00 |
| 90658 |
|
31 |
30 |
$0.00 |
| 90715 |
|
28 |
14 |
$0.00 |
| 4004F |
|
82 |
73 |
$0.00 |
| D5986 |
|
12 |
12 |
$0.00 |