| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27,975 |
26,737 |
$991K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
9,956 |
9,916 |
$807K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
6,433 |
6,376 |
$546K |
| 59410 |
|
959 |
694 |
$385K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,601 |
4,576 |
$340K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,192 |
2,182 |
$159K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,876 |
3,780 |
$112K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
27,580 |
27,369 |
$106K |
| H1000 |
Prenatal care, at-risk assessment |
1,918 |
1,742 |
$90K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14,453 |
14,370 |
$87K |
| 59515 |
|
141 |
105 |
$85K |
| 99188 |
|
5,094 |
5,072 |
$77K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,026 |
1,000 |
$48K |
| 90670 |
|
4,547 |
4,539 |
$25K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
329 |
322 |
$22K |
| 90723 |
|
1,640 |
1,639 |
$20K |
| 90686 |
|
6,072 |
6,050 |
$14K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
111 |
108 |
$9K |
| 0012A |
|
232 |
232 |
$8K |
| 0011A |
|
218 |
216 |
$6K |
| 99215 |
Prolong outpt/office vis |
101 |
91 |
$5K |
| 90655 |
|
2,651 |
2,638 |
$5K |
| 90651 |
|
735 |
735 |
$4K |
| 90633 |
|
1,050 |
1,047 |
$4K |
| 0064A |
|
97 |
88 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
43 |
42 |
$3K |
| 59025 |
Fetal non-stress test |
201 |
111 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
283 |
187 |
$2K |
| 90647 |
|
1,755 |
1,754 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
284 |
278 |
$2K |
| 0072A |
|
66 |
54 |
$2K |
| 90474 |
|
562 |
556 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
192 |
189 |
$1K |
| 90710 |
|
315 |
314 |
$1K |
| 99173 |
|
8,532 |
8,373 |
$1K |
| 99385 |
|
16 |
16 |
$1K |
| H0031 |
Mental health assessment, by non-physician |
80 |
72 |
$1K |
| 99383 |
|
12 |
12 |
$1K |
| 0071A |
|
41 |
37 |
$880.00 |
| 99381 |
|
13 |
13 |
$866.36 |
| 81003 |
|
712 |
675 |
$695.60 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
77 |
77 |
$556.42 |
| 0002A |
|
12 |
12 |
$480.00 |
| 90698 |
|
27 |
27 |
$420.00 |
| 81025 |
|
94 |
94 |
$417.94 |
| 0013A |
|
23 |
22 |
$400.00 |
| 0031A |
|
13 |
13 |
$360.00 |
| 85018 |
|
442 |
439 |
$359.34 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12 |
12 |
$224.64 |
| 3008F |
|
32,418 |
30,488 |
$207.55 |
| 92551 |
|
6,741 |
6,630 |
$172.76 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
13 |
13 |
$162.00 |
| 90620 |
|
25 |
25 |
$120.00 |
| 90681 |
|
552 |
551 |
$118.00 |
| 90700 |
|
27 |
27 |
$110.00 |
| 93000 |
|
12 |
12 |
$108.17 |
| 90734 |
|
152 |
152 |
$60.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
14 |
13 |
$32.44 |
| 90696 |
|
24 |
24 |
$32.02 |
| 90685 |
|
12 |
12 |
$10.00 |
| 36415 |
Collection of venous blood by venipuncture |
3,736 |
3,649 |
$5.00 |
| 3725F |
|
1,353 |
1,255 |
$0.08 |
| 3079F |
|
683 |
610 |
$0.02 |
| 1000F |
|
5,941 |
5,434 |
$0.01 |
| 1036F |
|
3,217 |
2,969 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
165 |
147 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
172 |
146 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
515 |
434 |
$0.00 |
| 91307 |
|
411 |
338 |
$0.00 |
| 3074F |
|
2,184 |
2,088 |
$0.00 |
| 1034F |
|
94 |
89 |
$0.00 |
| 0513F |
|
99 |
96 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
85 |
69 |
$0.00 |
| 1111F |
|
41 |
41 |
$0.00 |
| 3017F |
|
40 |
40 |
$0.00 |
| 3075F |
|
114 |
111 |
$0.00 |
| D1351 |
Sealant - per tooth |
71 |
30 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
275 |
243 |
$0.00 |
| 91306 |
|
88 |
78 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
294 |
255 |
$0.00 |
| 1126F |
|
34 |
32 |
$0.00 |
| 36410 |
|
51 |
48 |
$0.00 |
| D1330 |
|
216 |
186 |
$0.00 |
| 3351F |
|
47 |
46 |
$0.00 |
| 3014F |
|
121 |
103 |
$0.00 |
| 1125F |
|
17 |
16 |
$0.00 |
| 1038F |
|
13 |
13 |
$0.00 |
| 3352F |
|
12 |
12 |
$0.00 |
| D0240 |
|
21 |
15 |
$0.00 |
| 90697 |
|
65 |
64 |
$0.00 |
| 3044F |
|
14 |
14 |
$0.00 |
| 3353F |
|
13 |
13 |
$0.00 |
| 1160F |
|
164 |
152 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
610 |
539 |
$0.00 |
| 4004F |
|
732 |
705 |
$0.00 |
| 1039F |
|
324 |
303 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
175 |
151 |
$0.00 |
| 3078F |
|
1,862 |
1,693 |
$0.00 |
| 3015F |
|
433 |
405 |
$0.00 |
| 0502F |
|
287 |
217 |
$0.00 |
| D1120 |
Prophylaxis - child |
118 |
102 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 1159F |
|
199 |
187 |
$0.00 |
| 3077F |
|
40 |
37 |
$0.00 |
| D1110 |
Prophylaxis - adult |
98 |
84 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
357 |
312 |
$0.00 |
| 1033F |
|
143 |
122 |
$0.00 |
| D0190 |
|
359 |
299 |
$0.00 |
| 91300 |
|
15 |
15 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
53 |
43 |
$0.00 |
| 0521F |
|
17 |
16 |
$0.00 |