| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,561 |
4,993 |
$298K |
| 99383 |
|
2,184 |
2,058 |
$195K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,853 |
4,491 |
$152K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,684 |
1,614 |
$151K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,791 |
1,708 |
$144K |
| 99382 |
|
1,493 |
1,439 |
$137K |
| 99384 |
|
958 |
925 |
$101K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,255 |
1,109 |
$99K |
| 92551 |
|
10,962 |
10,217 |
$90K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,598 |
2,091 |
$70K |
| D0140 |
Limited oral evaluation - problem focused |
2,102 |
1,503 |
$65K |
| D1120 |
Prophylaxis - child |
2,493 |
2,044 |
$58K |
| D0330 |
Panoramic radiographic image |
1,208 |
936 |
$41K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,530 |
1,414 |
$38K |
| 90791 |
Psychiatric diagnostic evaluation |
948 |
515 |
$33K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
572 |
559 |
$33K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,485 |
2,038 |
$32K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
1,379 |
448 |
$32K |
| 92002 |
|
460 |
457 |
$31K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,720 |
1,145 |
$30K |
| 99401 |
|
1,466 |
1,345 |
$30K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
307 |
92 |
$24K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
3,950 |
549 |
$23K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
77 |
74 |
$21K |
| 90832 |
Psychotherapy, 30 minutes with patient |
791 |
353 |
$21K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
223 |
216 |
$18K |
| D9310 |
|
268 |
243 |
$13K |
| 96160 |
|
3,474 |
3,282 |
$10K |
| 99173 |
|
4,713 |
4,409 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
128 |
115 |
$9K |
| D0220 |
Intraoral - periapical first radiographic image |
933 |
663 |
$9K |
| D7140 |
Extraction, erupted tooth or exposed root |
102 |
50 |
$8K |
| D0272 |
Bitewings - two radiographic images |
749 |
488 |
$6K |
| 99201 |
|
156 |
154 |
$6K |
| D0210 |
Intraoral - complete series of radiographic images |
322 |
105 |
$4K |
| 90837 |
Psychotherapy, 53 minutes with patient |
119 |
46 |
$4K |
| D1351 |
Sealant - per tooth |
396 |
26 |
$3K |
| 99385 |
|
27 |
24 |
$2K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
62 |
12 |
$2K |
| 99386 |
|
14 |
13 |
$2K |
| 0001A |
|
48 |
47 |
$2K |
| 0002A |
|
41 |
41 |
$1K |
| 90834 |
Psychotherapy, 45 minutes with patient |
12 |
12 |
$820.41 |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
13 |
13 |
$617.50 |
| 36415 |
Collection of venous blood by venipuncture |
353 |
313 |
$609.01 |
| D1206 |
Topical application of fluoride varnish |
28 |
28 |
$524.78 |
| 0011A |
|
55 |
46 |
$430.44 |
| 85018 |
|
260 |
231 |
$369.68 |
| 90756 |
|
14 |
13 |
$346.58 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
34 |
27 |
$321.80 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
20 |
18 |
$254.13 |
| D0145 |
Oral evaluation for a patient under three years of age |
28 |
23 |
$208.75 |
| 90688 |
|
49 |
40 |
$104.46 |
| 81000 |
|
14 |
13 |
$33.60 |
| 81003 |
|
14 |
12 |
$32.45 |
| 90707 |
|
29 |
26 |
$0.00 |
| 90649 |
|
274 |
253 |
$0.00 |
| 90710 |
|
34 |
33 |
$0.00 |
| 90734 |
|
220 |
206 |
$0.00 |
| 90658 |
|
87 |
75 |
$0.00 |
| 90633 |
|
88 |
84 |
$0.00 |
| 90670 |
|
112 |
103 |
$0.00 |
| 90715 |
|
218 |
210 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
60 |
48 |
$0.00 |
| 90461 |
|
17 |
17 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |
| 90744 |
|
30 |
27 |
$0.00 |
| 3008F |
|
1,296 |
1,241 |
$0.00 |
| 99000 |
|
50 |
49 |
$0.00 |
| 3351F |
|
121 |
117 |
$0.00 |
| 99402 |
|
16 |
16 |
$0.00 |
| 90698 |
|
45 |
40 |
$0.00 |
| 90696 |
|
31 |
30 |
$0.00 |
| 90716 |
|
18 |
15 |
$0.00 |