| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
47,290 |
33,385 |
$8.52M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,902 |
1,515 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,435 |
1,115 |
$2K |
| 0012A |
|
746 |
378 |
$97.74 |
| 0011A |
|
751 |
388 |
$88.24 |
| G0008 |
Administration of influenza virus vaccine |
212 |
185 |
$15.30 |
| 99000 |
|
124 |
114 |
$5.40 |
| 0064A |
|
91 |
91 |
$1.54 |
| 36415 |
Collection of venous blood by venipuncture |
185 |
148 |
$1.50 |
| D1206 |
Topical application of fluoride varnish |
17,918 |
14,782 |
$0.00 |
| 3008F |
|
1,534 |
1,320 |
$0.00 |
| D1330 |
|
21,598 |
16,982 |
$0.00 |
| D1351 |
Sealant - per tooth |
5,329 |
1,464 |
$0.00 |
| D1310 |
|
19,712 |
15,435 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
7,783 |
6,493 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
948 |
646 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
3,135 |
2,541 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
22,244 |
6,619 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,531 |
2,055 |
$0.00 |
| 1036F |
|
1,399 |
1,175 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
3,456 |
3,083 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
579 |
414 |
$0.00 |
| 2001F |
|
1,404 |
1,207 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
17 |
16 |
$0.00 |
| 1125F |
|
152 |
135 |
$0.00 |
| 3079F |
|
143 |
123 |
$0.00 |
| 1126F |
|
502 |
456 |
$0.00 |
| D0602 |
|
81 |
81 |
$0.00 |
| 3074F |
|
238 |
212 |
$0.00 |
| D1353 |
|
25 |
12 |
$0.00 |
| D0601 |
|
127 |
126 |
$0.00 |
| 91301 |
|
790 |
758 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
64 |
63 |
$0.00 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
76 |
62 |
$0.00 |
| 3075F |
|
49 |
48 |
$0.00 |
| 0134A |
|
62 |
62 |
$0.00 |
| 90480 |
|
56 |
55 |
$0.00 |
| 90686 |
|
55 |
55 |
$0.00 |
| 90656 |
|
20 |
20 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
13 |
12 |
$0.00 |
| D0603 |
|
18 |
18 |
$0.00 |
| D1354 |
|
1,238 |
305 |
$0.00 |
| D0330 |
Panoramic radiographic image |
190 |
182 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
3,888 |
3,159 |
$0.00 |
| D0190 |
|
11,868 |
8,933 |
$0.00 |
| D9996 |
|
11,031 |
8,973 |
$0.00 |
| D1120 |
Prophylaxis - child |
7,497 |
6,118 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
12,274 |
10,083 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,094 |
675 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
585 |
442 |
$0.00 |
| 91313 |
|
44 |
44 |
$0.00 |
| D1110 |
Prophylaxis - adult |
1,949 |
1,703 |
$0.00 |
| 1159F |
|
1,331 |
1,161 |
$0.00 |
| 90662 |
|
100 |
89 |
$0.00 |
| D0270 |
|
145 |
132 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
60 |
56 |
$0.00 |
| 3078F |
|
393 |
353 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
72 |
68 |
$0.00 |
| 3077F |
|
55 |
53 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
103 |
96 |
$0.00 |
| 81003 |
|
36 |
35 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
57 |
52 |
$0.00 |
| 99173 |
|
13 |
13 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
38 |
37 |
$0.00 |
| 91322 |
|
34 |
34 |
$0.00 |