| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
18,764 |
18,474 |
$3.69M |
| D0140 |
Limited oral evaluation - problem focused |
12,853 |
12,049 |
$2.34M |
| 90837 |
Psychotherapy, 53 minutes with patient |
5,942 |
3,276 |
$1.63M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,409 |
4,694 |
$907K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
6,273 |
4,405 |
$843K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,739 |
2,216 |
$777K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,008 |
2,743 |
$767K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,389 |
3,333 |
$657K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
4,599 |
3,383 |
$554K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,751 |
1,645 |
$240K |
| D5899 |
|
1,838 |
1,076 |
$197K |
| 90832 |
Psychotherapy, 30 minutes with patient |
805 |
563 |
$181K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
1,367 |
1,151 |
$180K |
| D2331 |
|
1,508 |
1,055 |
$152K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
324 |
303 |
$112K |
| D2330 |
|
951 |
674 |
$82K |
| 90791 |
Psychiatric diagnostic evaluation |
179 |
168 |
$33K |
| 99215 |
Prolong outpt/office vis |
85 |
83 |
$30K |
| D2940 |
|
271 |
248 |
$26K |
| D2335 |
|
183 |
146 |
$23K |
| D2332 |
|
324 |
242 |
$23K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
247 |
199 |
$18K |
| D2140 |
|
162 |
127 |
$11K |
| 99205 |
Prolong outpt/office vis |
47 |
46 |
$9K |
| D1354 |
|
231 |
108 |
$6K |
| D1206 |
Topical application of fluoride varnish |
20,927 |
20,546 |
$5K |
| D1110 |
Prophylaxis - adult |
10,848 |
10,663 |
$5K |
| 99442 |
|
34 |
33 |
$4K |
| D2394 |
|
13 |
12 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
17 |
14 |
$3K |
| D1120 |
Prophylaxis - child |
10,074 |
9,911 |
$2K |
| D0330 |
Panoramic radiographic image |
3,193 |
3,145 |
$839.26 |
| D1351 |
Sealant - per tooth |
5,661 |
1,995 |
$726.67 |
| D0220 |
Intraoral - periapical first radiographic image |
11,572 |
11,204 |
$483.90 |
| D0230 |
Intraoral - periapical each additional radiographic image |
10,199 |
6,696 |
$475.78 |
| 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 |
17 |
13 |
$409.44 |
| D0274 |
Bitewings - four radiographic images |
6,965 |
6,847 |
$294.40 |
| 36415 |
Collection of venous blood by venipuncture |
900 |
847 |
$234.62 |
| 83037 |
|
596 |
574 |
$93.77 |
| D0272 |
Bitewings - two radiographic images |
4,109 |
4,044 |
$82.14 |
| D0210 |
Intraoral - complete series of radiographic images |
2,002 |
1,979 |
$67.88 |
| D0240 |
|
817 |
423 |
$59.85 |
| 80061 |
Lipid panel |
233 |
223 |
$50.20 |
| D0270 |
|
263 |
255 |
$7.01 |
| D1330 |
|
88 |
84 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
20 |
15 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
92 |
90 |
$0.00 |
| 90686 |
|
14 |
14 |
$0.00 |
| 36416 |
|
24 |
21 |
$0.00 |
| 82044 |
|
15 |
14 |
$0.00 |
| D4910 |
|
807 |
794 |
$0.00 |
| 90785 |
|
351 |
185 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,132 |
969 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
48 |
25 |
$0.00 |