| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,249 |
13,391 |
$1.51M |
| 90837 |
Psychotherapy, 53 minutes with patient |
3,633 |
2,484 |
$823K |
| D0999 |
Unspecified diagnostic procedure, by report |
1,218 |
1,144 |
$744K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,213 |
1,817 |
$438K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,675 |
2,594 |
$429K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,977 |
1,584 |
$426K |
| 90791 |
Psychiatric diagnostic evaluation |
704 |
683 |
$170K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,762 |
1,724 |
$170K |
| 99443 |
|
490 |
460 |
$92K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
998 |
998 |
$81K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
452 |
452 |
$64K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
387 |
387 |
$52K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,048 |
1,048 |
$44K |
| 0011A |
|
411 |
411 |
$44K |
| 0012A |
|
390 |
390 |
$43K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
501 |
482 |
$28K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
537 |
535 |
$26K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,037 |
1,036 |
$24K |
| 98968 |
|
178 |
124 |
$23K |
| V2020 |
Frames, purchases |
401 |
399 |
$23K |
| 0002A |
|
167 |
167 |
$20K |
| 0064A |
|
185 |
185 |
$19K |
| 0001A |
|
156 |
156 |
$18K |
| G9007 |
Coordinated care fee, scheduled team conference |
179 |
179 |
$18K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
96 |
95 |
$16K |
| 0072A |
|
180 |
180 |
$16K |
| 0071A |
|
174 |
173 |
$16K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
170 |
168 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
74 |
74 |
$11K |
| 98967 |
|
61 |
48 |
$9K |
| D1110 |
Prophylaxis - adult |
206 |
206 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
66 |
66 |
$8K |
| D1206 |
Topical application of fluoride varnish |
373 |
373 |
$7K |
| 92015 |
Determination of refractive state |
1,034 |
1,032 |
$7K |
| D1120 |
Prophylaxis - child |
128 |
128 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
307 |
306 |
$4K |
| 0004A |
|
27 |
27 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
2,655 |
2,437 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
28 |
15 |
$2K |
| 0134A |
|
12 |
12 |
$2K |
| 80305 |
|
167 |
155 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
70 |
70 |
$997.88 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
18 |
12 |
$950.00 |
| 81003 |
|
137 |
135 |
$825.78 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
42 |
42 |
$570.00 |
| 91300 |
|
438 |
414 |
$519.00 |
| D0330 |
Panoramic radiographic image |
14 |
14 |
$430.00 |
| 90686 |
|
972 |
972 |
$346.06 |
| D0140 |
Limited oral evaluation - problem focused |
24 |
24 |
$336.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
39 |
39 |
$321.18 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
95 |
93 |
$50.00 |
| 96127 |
|
13 |
12 |
$32.75 |
| 90461 |
|
39 |
39 |
$24.94 |
| 82962 |
|
37 |
36 |
$4.90 |
| 90670 |
|
168 |
168 |
$0.00 |
| 90633 |
|
16 |
16 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
25 |
25 |
$0.00 |
| 91313 |
|
12 |
12 |
$0.00 |
| D1330 |
|
512 |
511 |
$0.00 |
| 91307 |
|
433 |
401 |
$0.00 |
| 91301 |
|
963 |
928 |
$0.00 |
| 90680 |
|
40 |
40 |
$0.00 |
| 91306 |
|
184 |
184 |
$0.00 |
| 90647 |
|
40 |
40 |
$0.00 |
| 90723 |
|
53 |
53 |
$0.00 |
| 99000 |
|
16 |
15 |
$0.00 |