| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
2,092,275 |
1,983,005 |
$10.84M |
| 99502 |
|
10,886 |
9,359 |
$632K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
20,626 |
15,939 |
$543K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
20,719 |
15,951 |
$527K |
| 99501 |
|
10,289 |
7,626 |
$477K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,561 |
2,845 |
$333K |
| D0120 |
Periodic oral evaluation - established patient |
10,934 |
10,602 |
$322K |
| D1120 |
Prophylaxis - child |
8,777 |
8,530 |
$270K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,522 |
5,756 |
$240K |
| D1206 |
Topical application of fluoride varnish |
13,116 |
12,737 |
$233K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
9,042 |
7,728 |
$232K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15,546 |
13,145 |
$196K |
| D1110 |
Prophylaxis - adult |
4,437 |
4,304 |
$191K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
7,104 |
5,948 |
$154K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,308 |
911 |
$136K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,604 |
1,220 |
$127K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,224 |
854 |
$124K |
| D0220 |
Intraoral - periapical first radiographic image |
6,776 |
6,524 |
$114K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
3,155 |
2,650 |
$102K |
| D1351 |
Sealant - per tooth |
2,658 |
657 |
$87K |
| D0274 |
Bitewings - four radiographic images |
2,241 |
2,166 |
$81K |
| D0272 |
Bitewings - two radiographic images |
3,710 |
3,592 |
$77K |
| D0330 |
Panoramic radiographic image |
1,180 |
1,124 |
$76K |
| 86592 |
|
16,046 |
13,383 |
$74K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
773 |
559 |
$73K |
| D0230 |
Intraoral - periapical each additional radiographic image |
5,350 |
4,206 |
$70K |
| T1002 |
Rn services, up to 15 minutes |
3,020 |
1,872 |
$67K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
7,064 |
5,937 |
$64K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,207 |
1,153 |
$56K |
| 90651 |
|
2,178 |
1,824 |
$54K |
| 90715 |
|
5,133 |
4,321 |
$52K |
| 81025 |
|
6,732 |
5,302 |
$47K |
| 87070 |
|
5,158 |
3,578 |
$45K |
| 90716 |
|
1,617 |
1,418 |
$45K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
489 |
392 |
$44K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,274 |
2,683 |
$43K |
| D0140 |
Limited oral evaluation - problem focused |
910 |
881 |
$35K |
| 36415 |
Collection of venous blood by venipuncture |
14,317 |
12,015 |
$33K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
2,950 |
2,432 |
$32K |
| 90480 |
|
819 |
755 |
$29K |
| 91320 |
|
417 |
373 |
$28K |
| 90734 |
|
2,016 |
1,750 |
$24K |
| 90746 |
|
330 |
291 |
$24K |
| 90713 |
|
1,557 |
1,426 |
$20K |
| 90686 |
|
4,378 |
3,638 |
$19K |
| 83986 |
|
4,898 |
3,838 |
$16K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,882 |
1,310 |
$16K |
| D0240 |
|
872 |
693 |
$15K |
| 90636 |
|
112 |
95 |
$12K |
| 90619 |
|
4,000 |
3,183 |
$10K |
| 90620 |
|
721 |
584 |
$10K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,047 |
848 |
$9K |
| 82950 |
|
1,776 |
1,430 |
$9K |
| S9442 |
Birthing classes, non-physician provider, per session |
527 |
311 |
$9K |
| 91322 |
|
91 |
85 |
$8K |
| 59426 |
|
14 |
13 |
$8K |
| 99215 |
Prolong outpt/office vis |
91 |
66 |
$7K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
291 |
245 |
$7K |
| 90714 |
|
444 |
374 |
$7K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
59 |
44 |
$6K |
| 90707 |
|
243 |
221 |
$6K |
| 81003 |
|
3,330 |
2,632 |
$5K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
18 |
13 |
$5K |
| D4355 |
|
67 |
65 |
$5K |
| 87210 |
|
1,057 |
821 |
$4K |
| 99442 |
|
84 |
67 |
$3K |
| 90656 |
|
414 |
405 |
$3K |
| 99441 |
|
86 |
65 |
$3K |
| 99385 |
|
18 |
13 |
$3K |
| 99383 |
|
26 |
26 |
$2K |
| 0054A |
|
39 |
29 |
$2K |
| 0124A |
|
35 |
30 |
$2K |
| 92552 |
|
229 |
191 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
18 |
12 |
$1K |
| 11981 |
|
13 |
13 |
$1K |
| 90633 |
|
2,680 |
2,399 |
$1K |
| D1354 |
|
127 |
41 |
$1K |
| 0051A |
|
19 |
14 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
314 |
288 |
$1K |
| 85014 |
|
375 |
261 |
$998.97 |
| D7140 |
Extraction, erupted tooth or exposed root |
14 |
13 |
$889.56 |
| 96127 |
|
187 |
161 |
$717.58 |
| 99000 |
|
19,053 |
15,988 |
$621.67 |
| 0121A |
|
16 |
13 |
$585.00 |
| 99173 |
|
262 |
217 |
$544.55 |
| 90744 |
|
642 |
558 |
$489.92 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
41 |
25 |
$382.22 |
| 87205 |
|
60 |
48 |
$216.80 |
| 90710 |
|
706 |
618 |
$205.39 |
| 96160 |
|
89 |
51 |
$172.04 |
| 86593 |
|
17 |
12 |
$51.69 |
| 90696 |
|
146 |
126 |
$49.13 |
| 83655 |
|
531 |
450 |
$46.17 |
| 81001 |
|
14 |
14 |
$28.21 |
| G9920 |
Screening performed and negative |
9,187 |
7,598 |
$25.95 |
| D0350 |
|
706 |
677 |
$0.00 |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
29 |
26 |
$0.00 |
| 91312 |
|
56 |
48 |
$0.00 |
| 91308 |
|
16 |
12 |
$0.00 |
| 81329 |
|
29 |
26 |
$0.00 |
| GC284 |
|
47 |
44 |
$0.00 |
| 91321 |
|
26 |
26 |
$0.00 |
| 90670 |
|
227 |
197 |
$0.00 |
| D0190 |
|
17 |
17 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
37 |
28 |
$0.00 |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
29 |
26 |
$0.00 |
| 90685 |
|
12 |
12 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |
| D1310 |
|
4,904 |
4,755 |
$0.00 |
| D0601 |
|
680 |
664 |
$0.00 |
| D1330 |
|
5,087 |
4,936 |
$0.00 |
| 90723 |
|
38 |
34 |
$0.00 |
| D0603 |
|
2,731 |
2,647 |
$0.00 |
| D0001 |
|
928 |
898 |
$0.00 |
| D0602 |
|
488 |
478 |
$0.00 |
| 91305 |
|
229 |
166 |
$0.00 |
| 91319 |
|
105 |
103 |
$0.00 |
| 90647 |
|
32 |
25 |
$0.00 |
| 91307 |
|
48 |
38 |
$0.00 |
| 91318 |
|
52 |
50 |
$0.00 |