| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,048 |
5,625 |
$2.91M |
| 99347 |
|
1,951 |
504 |
$926K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,915 |
1,521 |
$739K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,547 |
909 |
$720K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,368 |
1,155 |
$649K |
| D0120 |
Periodic oral evaluation - established patient |
1,495 |
1,372 |
$594K |
| D0140 |
Limited oral evaluation - problem focused |
1,379 |
1,191 |
$505K |
| 90832 |
Psychotherapy, 30 minutes with patient |
465 |
286 |
$303K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
624 |
564 |
$295K |
| D7140 |
Extraction, erupted tooth or exposed root |
688 |
356 |
$153K |
| 0011A |
|
363 |
324 |
$151K |
| 0012A |
|
318 |
292 |
$142K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
749 |
593 |
$114K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
256 |
186 |
$87K |
| D1110 |
Prophylaxis - adult |
351 |
303 |
$72K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
218 |
144 |
$56K |
| 0064A |
|
131 |
128 |
$53K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
140 |
112 |
$45K |
| 99215 |
Prolong outpt/office vis |
74 |
64 |
$33K |
| D0274 |
Bitewings - four radiographic images |
709 |
627 |
$30K |
| D0220 |
Intraoral - periapical first radiographic image |
730 |
633 |
$25K |
| 0001A |
|
53 |
53 |
$24K |
| 90791 |
Psychiatric diagnostic evaluation |
45 |
44 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
60 |
53 |
$23K |
| 0002A |
|
45 |
45 |
$21K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
35 |
33 |
$17K |
| D0330 |
Panoramic radiographic image |
488 |
417 |
$17K |
| D1120 |
Prophylaxis - child |
452 |
408 |
$15K |
| 0071A |
|
45 |
30 |
$13K |
| 90686 |
|
262 |
215 |
$9K |
| 0072A |
|
17 |
17 |
$8K |
| 0054A |
|
12 |
12 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$6K |
| 99201 |
|
25 |
13 |
$6K |
| 91322 |
|
45 |
23 |
$5K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
15 |
13 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
282 |
270 |
$2K |
| D1206 |
Topical application of fluoride varnish |
17 |
17 |
$1K |
| 0134A |
|
30 |
16 |
$1K |
| 90688 |
|
197 |
145 |
$934.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
107 |
90 |
$925.91 |
| D0272 |
Bitewings - two radiographic images |
16 |
16 |
$910.00 |
| 90480 |
|
42 |
20 |
$733.20 |
| 90734 |
|
30 |
29 |
$519.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
18 |
12 |
$479.00 |
| 90651 |
|
29 |
25 |
$455.00 |
| 36415 |
Collection of venous blood by venipuncture |
2,246 |
1,784 |
$142.15 |
| 90461 |
|
52 |
41 |
$48.85 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
29 |
27 |
$19.42 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
1,536 |
1,170 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
471 |
427 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
299 |
253 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
359 |
306 |
$0.00 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
40 |
37 |
$0.00 |
| 99000 |
|
52 |
42 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12 |
12 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$0.00 |
| 85027 |
|
12 |
12 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
637 |
533 |
$0.00 |
| 81025 |
|
12 |
12 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
551 |
242 |
$0.00 |
| 99173 |
|
16 |
15 |
$0.00 |
| 90633 |
|
15 |
13 |
$0.00 |