| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,695 |
13,798 |
$7.46M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,415 |
5,625 |
$2.89M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,262 |
2,954 |
$1.53M |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,648 |
2,452 |
$995K |
| 0001A |
|
1,932 |
1,512 |
$732K |
| 0002A |
|
1,811 |
1,383 |
$693K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,539 |
3,961 |
$662K |
| 0054A |
|
1,191 |
1,116 |
$628K |
| 0124A |
|
1,122 |
1,115 |
$493K |
| D0220 |
Intraoral - periapical first radiographic image |
1,717 |
1,606 |
$463K |
| D0140 |
Limited oral evaluation - problem focused |
1,540 |
1,447 |
$441K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,483 |
661 |
$404K |
| 99215 |
Prolong outpt/office vis |
846 |
758 |
$386K |
| 42700 |
|
1,085 |
846 |
$383K |
| 90837 |
Psychotherapy, 53 minutes with patient |
730 |
517 |
$377K |
| 0071A |
|
1,025 |
624 |
$319K |
| W0037 |
|
10,280 |
10,280 |
$315K |
| 0072A |
|
842 |
558 |
$295K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
3,399 |
2,700 |
$272K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
700 |
657 |
$269K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
380 |
348 |
$197K |
| 0154A |
|
380 |
372 |
$183K |
| 90832 |
Psychotherapy, 30 minutes with patient |
413 |
291 |
$175K |
| D1120 |
Prophylaxis - child |
474 |
474 |
$131K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
2,159 |
1,448 |
$124K |
| 0004A |
|
459 |
241 |
$124K |
| D1206 |
Topical application of fluoride varnish |
838 |
835 |
$121K |
| 0031A |
|
319 |
226 |
$114K |
| 0034A |
|
171 |
155 |
$97K |
| 45500 |
|
344 |
241 |
$95K |
| 0134A |
|
312 |
311 |
$91K |
| 0064A |
|
167 |
147 |
$87K |
| 0052A |
|
163 |
155 |
$66K |
| 0011A |
|
167 |
113 |
$49K |
| 0074A |
|
142 |
141 |
$47K |
| 90834 |
Psychotherapy, 45 minutes with patient |
117 |
81 |
$47K |
| 90791 |
Psychiatric diagnostic evaluation |
107 |
94 |
$46K |
| 0051A |
|
137 |
135 |
$46K |
| D7140 |
Extraction, erupted tooth or exposed root |
859 |
668 |
$42K |
| D0603 |
|
353 |
353 |
$42K |
| 99600 |
Unlisted home visit service or procedure |
208 |
125 |
$40K |
| 0012A |
|
106 |
87 |
$39K |
| 99506 |
|
107 |
86 |
$30K |
| D0270 |
|
450 |
413 |
$29K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
55 |
28 |
$27K |
| D1351 |
Sealant - per tooth |
153 |
43 |
$15K |
| 0081A |
|
89 |
88 |
$14K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,256 |
1,097 |
$11K |
| 0003A |
|
30 |
18 |
$9K |
| 0173A |
|
12 |
12 |
$8K |
| 0083A |
|
12 |
12 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
18 |
12 |
$6K |
| D0274 |
Bitewings - four radiographic images |
15 |
15 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
57 |
57 |
$4K |
| 98966 |
|
294 |
268 |
$4K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
212 |
186 |
$3K |
| 0082A |
|
42 |
42 |
$3K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
332 |
285 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
29 |
12 |
$1K |
| 98967 |
|
41 |
40 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
253 |
234 |
$348.67 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
182 |
164 |
$257.93 |
| 99441 |
|
44 |
43 |
$184.88 |
| 99442 |
|
17 |
16 |
$163.17 |
| 70450 |
Computed tomography, head or brain; without contrast material |
12 |
12 |
$63.54 |
| 71046 |
Radiologic examination, chest; 2 views |
26 |
25 |
$11.25 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
50 |
14 |
$0.00 |
| 1 |
Lens, 1.54-1.65 p/1.60-1.79g |
29 |
29 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
113 |
52 |
$0.00 |
| 64000 |
|
51 |
49 |
$0.00 |
| 97162 |
|
21 |
13 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
14 |
14 |
$0.00 |
| 00001 |
|
56 |
56 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
13 |
13 |
$0.00 |
| 90686 |
|
26 |
13 |
$0.00 |