| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
6,468 |
5,990 |
$2.79M |
| 99253 |
|
2,949 |
2,840 |
$521K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,051 |
954 |
$269K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
714 |
691 |
$250K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
294 |
281 |
$98K |
| D8670 |
Periodic orthodontic treatment visit |
780 |
702 |
$71K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,251 |
578 |
$68K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
898 |
822 |
$44K |
| 90837 |
Psychotherapy, 53 minutes with patient |
507 |
304 |
$34K |
| D0140 |
Limited oral evaluation - problem focused |
620 |
595 |
$26K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
427 |
388 |
$26K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
534 |
433 |
$19K |
| 70450 |
Computed tomography, head or brain; without contrast material |
576 |
518 |
$18K |
| D7140 |
Extraction, erupted tooth or exposed root |
173 |
101 |
$11K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
903 |
643 |
$8K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
425 |
417 |
$8K |
| D0330 |
Panoramic radiographic image |
274 |
272 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
187 |
182 |
$6K |
| D1120 |
Prophylaxis - child |
155 |
155 |
$4K |
| D1110 |
Prophylaxis - adult |
123 |
121 |
$4K |
| D0210 |
Intraoral - complete series of radiographic images |
102 |
100 |
$3K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
15 |
13 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
160 |
159 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
406 |
391 |
$3K |
| D0274 |
Bitewings - four radiographic images |
103 |
102 |
$3K |
| 99252 |
|
16 |
12 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
124 |
124 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
34 |
27 |
$2K |
| 99350 |
Prolong home eval add 15m |
57 |
56 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
19 |
15 |
$2K |
| 71010 |
|
251 |
190 |
$2K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
25 |
25 |
$2K |
| 93000 |
|
89 |
87 |
$1K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
38 |
38 |
$1K |
| 99254 |
|
25 |
25 |
$1K |
| 70496 |
|
28 |
28 |
$1K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
28 |
28 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
156 |
118 |
$1K |
| 00740 |
|
12 |
12 |
$1K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
26 |
26 |
$950.41 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
12 |
$940.00 |
| D9995 |
|
170 |
170 |
$840.00 |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
16 |
16 |
$797.66 |
| 70498 |
|
16 |
16 |
$646.57 |
| 00812 |
|
18 |
13 |
$498.48 |
| D0270 |
|
46 |
46 |
$365.83 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$295.10 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
34 |
12 |
$277.02 |
| 93296 |
|
12 |
12 |
$196.37 |
| 71046 |
Radiologic examination, chest; 2 views |
13 |
13 |
$114.27 |
| 76937 |
|
14 |
12 |
$42.43 |
| D0460 |
|
18 |
18 |
$28.51 |
| 77001 |
|
16 |
13 |
$14.11 |
| D9430 |
|
12 |
12 |
$0.00 |
| G9637 |
Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) |
90 |
57 |
$0.00 |