| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
39,920 |
34,241 |
$2.00M |
| T1015 |
Clinic visit/encounter, all-inclusive |
46,623 |
38,584 |
$693K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
6,313 |
5,878 |
$514K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,097 |
4,792 |
$409K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,203 |
4,638 |
$396K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
9,240 |
7,995 |
$314K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,615 |
3,994 |
$296K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,549 |
3,317 |
$283K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
11,437 |
10,512 |
$242K |
| 59425 |
|
3,992 |
2,914 |
$226K |
| D1110 |
Prophylaxis - adult |
4,050 |
3,387 |
$185K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16,240 |
14,797 |
$171K |
| D0330 |
Panoramic radiographic image |
3,378 |
2,908 |
$161K |
| D9999 |
Unspecified adjunctive procedure, by report |
12,294 |
9,971 |
$145K |
| D0120 |
Periodic oral evaluation - established patient |
6,547 |
5,636 |
$139K |
| D1120 |
Prophylaxis - child |
4,239 |
3,730 |
$137K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,359 |
929 |
$102K |
| D1206 |
Topical application of fluoride varnish |
4,759 |
4,025 |
$100K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,640 |
2,343 |
$95K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,911 |
1,204 |
$76K |
| D7140 |
Extraction, erupted tooth or exposed root |
824 |
509 |
$72K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,224 |
779 |
$70K |
| D0140 |
Limited oral evaluation - problem focused |
1,831 |
1,495 |
$66K |
| D0274 |
Bitewings - four radiographic images |
2,131 |
1,684 |
$56K |
| D0210 |
Intraoral - complete series of radiographic images |
1,773 |
1,546 |
$52K |
| 59426 |
|
684 |
416 |
$42K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,717 |
1,640 |
$32K |
| 59430 |
|
235 |
175 |
$27K |
| 92551 |
|
6,029 |
5,605 |
$26K |
| 99381 |
|
392 |
339 |
$23K |
| 92552 |
|
1,673 |
1,548 |
$17K |
| D0220 |
Intraoral - periapical first radiographic image |
1,264 |
990 |
$16K |
| D0272 |
Bitewings - two radiographic images |
761 |
582 |
$14K |
| 97802 |
|
2,999 |
2,846 |
$13K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
659 |
442 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
173 |
143 |
$12K |
| 90834 |
Psychotherapy, 45 minutes with patient |
172 |
95 |
$11K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,441 |
1,279 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
129 |
123 |
$8K |
| 99383 |
|
87 |
80 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
766 |
656 |
$6K |
| 87430 |
|
743 |
677 |
$6K |
| 85018 |
|
2,847 |
2,603 |
$6K |
| 99173 |
|
7,193 |
6,666 |
$6K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
47 |
41 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
276 |
237 |
$5K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
23 |
14 |
$4K |
| 90473 |
|
467 |
445 |
$4K |
| D0145 |
Oral evaluation for a patient under three years of age |
100 |
60 |
$3K |
| 81025 |
|
404 |
346 |
$2K |
| D4910 |
|
43 |
28 |
$2K |
| 81003 |
|
1,270 |
1,143 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
15 |
14 |
$2K |
| 90686 |
|
4,246 |
3,860 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
259 |
251 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
182 |
151 |
$1K |
| 36416 |
|
739 |
641 |
$1K |
| 99384 |
|
12 |
12 |
$797.58 |
| 80305 |
|
86 |
71 |
$641.34 |
| D0230 |
Intraoral - periapical each additional radiographic image |
72 |
28 |
$461.00 |
| 82948 |
|
518 |
453 |
$413.50 |
| 90474 |
|
29 |
27 |
$356.25 |
| 36415 |
Collection of venous blood by venipuncture |
168 |
152 |
$301.32 |
| 90716 |
|
67 |
67 |
$235.60 |
| 90651 |
|
1,509 |
1,390 |
$214.32 |
| 90707 |
|
55 |
55 |
$148.53 |
| 90633 |
|
1,986 |
1,828 |
$130.03 |
| 96127 |
|
993 |
900 |
$100.61 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
124 |
111 |
$8.08 |
| 90681 |
|
1,111 |
1,014 |
$5.54 |
| 90723 |
|
3,431 |
3,142 |
$0.00 |
| 90647 |
|
3,139 |
2,881 |
$0.00 |
| 90620 |
|
86 |
81 |
$0.00 |
| 90677 |
|
380 |
359 |
$0.00 |
| 90696 |
|
86 |
83 |
$0.00 |
| 90656 |
|
69 |
69 |
$0.00 |
| 90619 |
|
72 |
69 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
111 |
101 |
$0.00 |
| 90660 |
|
47 |
47 |
$0.00 |
| D1330 |
|
12 |
12 |
$0.00 |
| 90670 |
|
3,759 |
3,455 |
$0.00 |
| 90671 |
|
26 |
25 |
$0.00 |
| 90715 |
|
157 |
146 |
$0.00 |
| 90672 |
|
365 |
322 |
$0.00 |
| 90734 |
|
1,206 |
1,053 |
$0.00 |
| D1999 |
|
236 |
116 |
$0.00 |
| 90710 |
|
494 |
448 |
$0.00 |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
88 |
79 |
$0.00 |
| 90700 |
|
40 |
40 |
$0.00 |