| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
3,671 |
863 |
$295K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,587 |
2,211 |
$184K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,177 |
1,220 |
$165K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,664 |
1,448 |
$150K |
| D1110 |
Prophylaxis - adult |
1,357 |
1,192 |
$88K |
| 90837 |
Psychotherapy, 53 minutes with patient |
663 |
423 |
$70K |
| D0120 |
Periodic oral evaluation - established patient |
1,647 |
1,453 |
$67K |
| D0330 |
Panoramic radiographic image |
644 |
545 |
$47K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
402 |
376 |
$46K |
| D0274 |
Bitewings - four radiographic images |
529 |
455 |
$23K |
| D0220 |
Intraoral - periapical first radiographic image |
1,037 |
866 |
$20K |
| 90832 |
Psychotherapy, 30 minutes with patient |
327 |
205 |
$19K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
217 |
184 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
698 |
651 |
$9K |
| 90791 |
Psychiatric diagnostic evaluation |
59 |
53 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
79 |
56 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
142 |
103 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
46 |
46 |
$4K |
| 80305 |
|
344 |
240 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
102 |
60 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
13 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
102 |
51 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
83 |
40 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$1K |
| 87807 |
|
61 |
59 |
$686.21 |
| 80061 |
Lipid panel |
13 |
13 |
$275.07 |
| 80053 |
Comprehensive metabolic panel |
12 |
12 |
$143.54 |
| 3074F |
|
210 |
168 |
$70.00 |
| 3078F |
|
117 |
97 |
$30.00 |
| 3079F |
|
17 |
13 |
$10.00 |