| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
577,759 |
435,216 |
$3.09M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,569 |
17,381 |
$1.40M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,352 |
12,076 |
$1.20M |
| 59426 |
|
566 |
494 |
$434K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,644 |
2,179 |
$328K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
1,939 |
1,731 |
$303K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,483 |
1,407 |
$278K |
| D1120 |
Prophylaxis - child |
9,001 |
8,743 |
$269K |
| 59430 |
|
1,938 |
1,729 |
$244K |
| D0120 |
Periodic oral evaluation - established patient |
7,091 |
6,901 |
$202K |
| D1208 |
Topical application of fluoride, excluding varnish |
10,402 |
10,081 |
$183K |
| D1351 |
Sealant - per tooth |
5,963 |
1,662 |
$181K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,650 |
3,505 |
$178K |
| D0330 |
Panoramic radiographic image |
2,454 |
2,352 |
$153K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
11,500 |
9,553 |
$145K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
3,266 |
2,528 |
$135K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,375 |
1,119 |
$128K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
5,193 |
4,288 |
$122K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,510 |
2,046 |
$118K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,600 |
3,043 |
$107K |
| D0272 |
Bitewings - two radiographic images |
5,206 |
5,054 |
$105K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
13,178 |
10,485 |
$102K |
| D2140 |
|
1,192 |
766 |
$89K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,002 |
845 |
$85K |
| D0220 |
Intraoral - periapical first radiographic image |
4,678 |
4,501 |
$77K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
4,622 |
3,920 |
$74K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,355 |
1,032 |
$64K |
| T1002 |
Rn services, up to 15 minutes |
1,763 |
1,410 |
$62K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
2,242 |
1,829 |
$60K |
| D1110 |
Prophylaxis - adult |
1,445 |
1,363 |
$60K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,472 |
4,175 |
$59K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
636 |
530 |
$50K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
5,166 |
3,977 |
$44K |
| 90837 |
Psychotherapy, 53 minutes with patient |
606 |
268 |
$43K |
| 99215 |
Prolong outpt/office vis |
535 |
432 |
$42K |
| 81025 |
|
5,355 |
4,411 |
$40K |
| 96127 |
|
8,623 |
6,537 |
$38K |
| D0274 |
Bitewings - four radiographic images |
1,094 |
1,035 |
$38K |
| 80061 |
Lipid panel |
3,645 |
2,784 |
$37K |
| 86787 |
|
2,734 |
2,064 |
$34K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
362 |
230 |
$33K |
| D7140 |
Extraction, erupted tooth or exposed root |
460 |
313 |
$31K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,302 |
932 |
$30K |
| 86850 |
|
2,605 |
2,003 |
$28K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
325 |
257 |
$27K |
| 82947 |
|
5,674 |
4,135 |
$24K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,657 |
2,755 |
$23K |
| 36415 |
Collection of venous blood by venipuncture |
15,604 |
11,743 |
$22K |
| 99205 |
Prolong outpt/office vis |
267 |
212 |
$21K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
254 |
186 |
$20K |
| 82950 |
|
4,085 |
3,189 |
$20K |
| 90834 |
Psychotherapy, 45 minutes with patient |
312 |
230 |
$20K |
| 80053 |
Comprehensive metabolic panel |
2,934 |
2,519 |
$18K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,679 |
2,279 |
$17K |
| 87210 |
|
3,256 |
2,871 |
$16K |
| 86592 |
|
3,140 |
2,597 |
$15K |
| 81002 |
|
12,858 |
8,001 |
$14K |
| 90715 |
|
775 |
656 |
$13K |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,445 |
1,222 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
798 |
657 |
$11K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
61 |
40 |
$11K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
34 |
26 |
$11K |
| 87081 |
|
1,681 |
1,365 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
119 |
95 |
$9K |
| 99385 |
|
53 |
53 |
$8K |
| 96160 |
|
2,399 |
1,997 |
$8K |
| 86900 |
|
2,503 |
1,937 |
$7K |
| 86901 |
|
2,501 |
1,937 |
$7K |
| 59025 |
Fetal non-stress test |
152 |
103 |
$6K |
| 80050 |
General health panel |
628 |
471 |
$6K |
| 92587 |
|
5,009 |
4,141 |
$6K |
| 82105 |
|
591 |
449 |
$5K |
| 90713 |
|
117 |
114 |
$5K |
| 81003 |
|
4,315 |
3,235 |
$4K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
900 |
684 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
30 |
30 |
$4K |
| 90651 |
|
562 |
428 |
$4K |
| 86803 |
|
458 |
283 |
$4K |
| 85018 |
|
1,312 |
1,150 |
$4K |
| 90686 |
|
3,391 |
2,863 |
$3K |
| 90734 |
|
729 |
554 |
$3K |
| 90832 |
Psychotherapy, 30 minutes with patient |
68 |
56 |
$3K |
| 99383 |
|
31 |
27 |
$2K |
| 87400 |
|
164 |
76 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,208 |
4,399 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,214 |
4,401 |
$2K |
| 99381 |
|
17 |
13 |
$2K |
| 96161 |
|
886 |
419 |
$2K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
4,972 |
4,164 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
37 |
37 |
$1K |
| 90474 |
|
94 |
80 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$996.78 |
| 90746 |
|
13 |
13 |
$921.20 |
| D7111 |
|
16 |
14 |
$907.52 |
| 99173 |
|
6,513 |
5,410 |
$795.49 |
| 90480 |
|
12 |
12 |
$780.00 |
| 90620 |
|
148 |
115 |
$525.00 |
| 69210 |
|
13 |
13 |
$518.44 |
| 81001 |
|
246 |
204 |
$445.10 |
| 82607 |
|
15 |
14 |
$369.11 |
| 82746 |
|
15 |
14 |
$359.91 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
47 |
38 |
$321.53 |
| 82728 |
|
15 |
14 |
$308.12 |
| 90647 |
|
369 |
310 |
$248.04 |
| 90656 |
|
206 |
198 |
$243.36 |
| 83550 |
|
15 |
14 |
$213.99 |
| 86762 |
|
1,555 |
1,258 |
$199.93 |
| 82951 |
|
12 |
12 |
$196.44 |
| 90473 |
|
14 |
13 |
$178.23 |
| 83540 |
|
15 |
14 |
$158.73 |
| 86593 |
|
1,910 |
1,586 |
$139.95 |
| 87340 |
|
1,550 |
1,256 |
$129.46 |
| 83655 |
|
418 |
396 |
$128.10 |
| 85045 |
|
15 |
14 |
$98.04 |
| 83020 |
|
683 |
554 |
$78.84 |
| 82465 |
|
26 |
26 |
$71.52 |
| 90633 |
|
641 |
544 |
$46.00 |
| 94760 |
|
149 |
130 |
$2.13 |
| 3079F |
|
252 |
230 |
$0.00 |
| 0501F |
|
1,459 |
942 |
$0.00 |
| 3074F |
|
249 |
219 |
$0.00 |
| 0500F |
|
1,467 |
948 |
$0.00 |
| 90680 |
|
92 |
80 |
$0.00 |
| 90723 |
|
535 |
418 |
$0.00 |
| 1036F |
|
567 |
499 |
$0.00 |
| 82677 |
|
208 |
174 |
$0.00 |
| 1034F |
|
32 |
32 |
$0.00 |
| 0503F |
|
923 |
770 |
$0.00 |
| 3075F |
|
80 |
75 |
$0.00 |
| 90677 |
|
135 |
105 |
$0.00 |
| 90696 |
|
61 |
50 |
$0.00 |
| 3080F |
|
87 |
81 |
$0.00 |
| 3044F |
|
57 |
57 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$0.00 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
12 |
12 |
$0.00 |
| 90710 |
|
200 |
159 |
$0.00 |
| 84702 |
|
406 |
340 |
$0.00 |
| 90670 |
|
744 |
601 |
$0.00 |
| 3077F |
|
288 |
266 |
$0.00 |
| 4004F |
|
107 |
90 |
$0.00 |
| 3078F |
|
280 |
248 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
12 |
12 |
$0.00 |
| 86336 |
|
208 |
174 |
$0.00 |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
38 |
33 |
$0.00 |
| 90672 |
|
30 |
29 |
$0.00 |
| 90700 |
|
14 |
14 |
$0.00 |
| 1032F |
|
38 |
37 |
$0.00 |