| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28,045 |
24,446 |
$1.49M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28,583 |
25,864 |
$1.06M |
| D0120 |
Periodic oral evaluation - established patient |
15,948 |
15,590 |
$486K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
3,829 |
2,523 |
$419K |
| D1120 |
Prophylaxis - child |
10,703 |
10,413 |
$391K |
| D1206 |
Topical application of fluoride varnish |
16,962 |
16,492 |
$306K |
| D1110 |
Prophylaxis - adult |
4,924 |
4,785 |
$247K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
6,362 |
5,987 |
$246K |
| D0272 |
Bitewings - two radiographic images |
8,630 |
8,324 |
$221K |
| D1351 |
Sealant - per tooth |
5,404 |
2,209 |
$155K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,413 |
998 |
$135K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
1,229 |
1,171 |
$94K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
387 |
193 |
$83K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,061 |
977 |
$57K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,329 |
5,959 |
$40K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
567 |
552 |
$36K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
783 |
750 |
$36K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
1,201 |
1,145 |
$29K |
| D0274 |
Bitewings - four radiographic images |
872 |
849 |
$28K |
| D0330 |
Panoramic radiographic image |
787 |
703 |
$27K |
| 99215 |
Prolong outpt/office vis |
391 |
327 |
$26K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
331 |
312 |
$21K |
| 99243 |
|
353 |
278 |
$21K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
413 |
406 |
$17K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
98 |
95 |
$13K |
| D0220 |
Intraoral - periapical first radiographic image |
1,479 |
1,378 |
$13K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
465 |
450 |
$12K |
| 11721 |
|
1,018 |
731 |
$11K |
| 97597 |
|
740 |
365 |
$10K |
| 92567 |
|
1,497 |
1,312 |
$10K |
| 0240U |
|
66 |
63 |
$9K |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
117 |
115 |
$9K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
565 |
525 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,452 |
1,399 |
$7K |
| 90461 |
|
1,026 |
951 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
219 |
197 |
$6K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
213 |
207 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
75 |
71 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
66 |
66 |
$4K |
| 92557 |
|
205 |
179 |
$4K |
| 90686 |
|
4,207 |
4,022 |
$4K |
| 0071A |
|
100 |
93 |
$4K |
| 95886 |
|
76 |
65 |
$4K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
579 |
281 |
$3K |
| 0072A |
|
80 |
76 |
$3K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
247 |
88 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
84 |
77 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
47 |
41 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
224 |
201 |
$2K |
| 96127 |
|
326 |
273 |
$2K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
551 |
348 |
$2K |
| D0240 |
|
227 |
215 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
32 |
27 |
$1K |
| 45380 |
Colonoscopy, flexible; with biopsy, single or multiple |
18 |
12 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
240 |
221 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
179 |
142 |
$823.15 |
| 99223 |
Prolong inpt eval add15 m |
17 |
13 |
$793.47 |
| 69210 |
|
71 |
53 |
$672.54 |
| 11720 |
|
58 |
40 |
$493.46 |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
13 |
13 |
$478.47 |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
16 |
13 |
$398.40 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
41 |
40 |
$298.85 |
| 36415 |
Collection of venous blood by venipuncture |
389 |
362 |
$268.92 |
| D0230 |
Intraoral - periapical each additional radiographic image |
50 |
25 |
$245.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
46 |
45 |
$231.49 |
| 80061 |
Lipid panel |
14 |
14 |
$163.13 |
| 90670 |
|
67 |
64 |
$143.17 |
| 92551 |
|
32 |
27 |
$138.47 |
| 90656 |
|
273 |
254 |
$133.18 |
| 82948 |
|
53 |
37 |
$83.96 |
| 94060 |
|
18 |
14 |
$79.50 |
| 86140 |
|
15 |
15 |
$67.30 |
| 99173 |
|
16 |
12 |
$64.72 |
| 85651 |
|
13 |
13 |
$42.78 |
| 94729 |
|
16 |
12 |
$39.35 |
| 99307 |
|
26 |
12 |
$18.20 |
| 99000 |
|
93 |
93 |
$9.45 |
| 91307 |
|
214 |
193 |
$0.21 |
| D9987 |
|
378 |
368 |
$0.00 |
| D9986 |
|
702 |
686 |
$0.00 |
| 0502F |
|
32 |
25 |
$0.00 |
| 4266F |
|
27 |
13 |
$0.00 |
| 90685 |
|
16 |
13 |
$0.00 |
| 4261F |
|
27 |
13 |
$0.00 |
| D0603 |
|
120 |
110 |
$0.00 |
| 90698 |
|
30 |
30 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 36416 |
|
17 |
12 |
$0.00 |