| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25,852 |
17,969 |
$886K |
| H1000 |
Prenatal care, at-risk assessment |
13,426 |
8,165 |
$811K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,596 |
5,432 |
$337K |
| D0330 |
Panoramic radiographic image |
3,918 |
3,840 |
$140K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,960 |
3,896 |
$133K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,142 |
1,641 |
$99K |
| D1110 |
Prophylaxis - adult |
3,333 |
3,249 |
$94K |
| 81003 |
|
21,021 |
13,558 |
$86K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,464 |
1,015 |
$85K |
| D0120 |
Periodic oral evaluation - established patient |
5,507 |
5,284 |
$75K |
| D1120 |
Prophylaxis - child |
3,002 |
2,866 |
$72K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,488 |
1,785 |
$70K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
924 |
617 |
$61K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,259 |
821 |
$54K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,286 |
586 |
$53K |
| D1351 |
Sealant - per tooth |
7,546 |
1,518 |
$51K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,921 |
3,808 |
$51K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
858 |
589 |
$49K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
914 |
550 |
$48K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,455 |
3,221 |
$32K |
| D0272 |
Bitewings - two radiographic images |
6,153 |
6,013 |
$25K |
| 92551 |
|
7,947 |
5,026 |
$24K |
| D1206 |
Topical application of fluoride varnish |
7,035 |
6,787 |
$22K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
385 |
261 |
$22K |
| 85018 |
|
10,982 |
7,603 |
$21K |
| 90791 |
Psychiatric diagnostic evaluation |
334 |
237 |
$21K |
| D0220 |
Intraoral - periapical first radiographic image |
10,194 |
9,728 |
$20K |
| 99383 |
|
245 |
201 |
$15K |
| D0274 |
Bitewings - four radiographic images |
1,506 |
1,443 |
$15K |
| D0230 |
Intraoral - periapical each additional radiographic image |
8,765 |
8,023 |
$15K |
| D0140 |
Limited oral evaluation - problem focused |
1,519 |
1,473 |
$14K |
| 81025 |
|
3,469 |
2,488 |
$13K |
| D0603 |
|
933 |
909 |
$12K |
| 99381 |
|
142 |
128 |
$12K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
171 |
124 |
$12K |
| 99384 |
|
176 |
119 |
$11K |
| D1330 |
|
5,636 |
5,452 |
$10K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
449 |
356 |
$9K |
| 1111F |
|
51,995 |
30,771 |
$9K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
148 |
108 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,710 |
741 |
$8K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
694 |
495 |
$7K |
| 99385 |
|
77 |
62 |
$7K |
| 99443 |
|
422 |
185 |
$6K |
| D0210 |
Intraoral - complete series of radiographic images |
143 |
143 |
$6K |
| D1310 |
|
5,273 |
5,125 |
$6K |
| D1999 |
|
73 |
73 |
$4K |
| 90461 |
|
1,261 |
962 |
$4K |
| 99442 |
|
456 |
229 |
$4K |
| 3078F |
|
35,326 |
21,828 |
$4K |
| 3725F |
|
35,076 |
20,928 |
$4K |
| D7140 |
Extraction, erupted tooth or exposed root |
124 |
95 |
$3K |
| 3074F |
|
37,956 |
23,925 |
$3K |
| 59430 |
|
33 |
25 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
543 |
408 |
$2K |
| 99382 |
|
47 |
25 |
$2K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
55 |
50 |
$2K |
| 99205 |
Prolong outpt/office vis |
15 |
14 |
$2K |
| D0145 |
Oral evaluation for a patient under three years of age |
29 |
29 |
$2K |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
12,967 |
7,634 |
$1K |
| 1126F |
|
37,737 |
22,781 |
$1K |
| 1000F |
|
36,986 |
22,141 |
$1K |
| 1036F |
|
35,133 |
21,471 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
1,975 |
1,429 |
$1K |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
22,900 |
13,666 |
$929.94 |
| 99441 |
|
202 |
115 |
$925.98 |
| 96160 |
|
31,471 |
15,064 |
$695.15 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
123 |
68 |
$679.69 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
29 |
24 |
$590.20 |
| 90834 |
Psychotherapy, 45 minutes with patient |
26 |
15 |
$562.84 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
78 |
28 |
$516.60 |
| 82274 |
|
157 |
101 |
$510.28 |
| H0049 |
Alcohol and/or drug screening |
18,880 |
10,278 |
$498.79 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
155 |
62 |
$458.25 |
| 1160F |
|
44,100 |
26,243 |
$412.18 |
| 3079F |
|
5,498 |
3,397 |
$394.11 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
30,697 |
17,544 |
$370.19 |
| D0999 |
Unspecified diagnostic procedure, by report |
14 |
14 |
$280.00 |
| 1159F |
|
44,353 |
26,365 |
$276.70 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
58 |
40 |
$273.21 |
| 96127 |
|
20,932 |
11,931 |
$261.00 |
| 90651 |
|
460 |
249 |
$216.18 |
| 0521F |
|
728 |
561 |
$200.26 |
| 1158F |
|
1,882 |
1,478 |
$191.26 |
| 1125F |
|
2,436 |
1,730 |
$184.41 |
| D9999 |
Unspecified adjunctive procedure, by report |
85 |
85 |
$180.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,257 |
1,062 |
$177.37 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
62 |
43 |
$158.50 |
| 3075F |
|
1,430 |
879 |
$113.97 |
| 0502F |
|
1,411 |
844 |
$109.94 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,123 |
943 |
$97.90 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
28 |
25 |
$86.67 |
| 3080F |
|
151 |
92 |
$86.47 |
| 3077F |
|
699 |
395 |
$76.52 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
19 |
15 |
$72.25 |
| 99459 |
|
13 |
12 |
$62.29 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
82 |
50 |
$58.22 |
| 1034F |
|
652 |
354 |
$25.68 |
| 4000F |
|
267 |
112 |
$25.22 |
| 36416 |
|
1,722 |
1,222 |
$15.00 |
| 1170F |
|
78 |
52 |
$12.61 |
| 3048F |
|
658 |
440 |
$12.61 |
| 90686 |
|
1,515 |
1,105 |
$10.01 |
| 99173 |
|
4,566 |
2,864 |
$8.54 |
| 90633 |
|
256 |
199 |
$0.00 |
| 90670 |
|
449 |
226 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
162 |
145 |
$0.00 |
| 90672 |
|
103 |
102 |
$0.00 |
| 99177 |
|
1,868 |
1,441 |
$0.00 |
| 3050F |
|
27 |
25 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
85 |
73 |
$0.00 |
| 90715 |
|
17 |
13 |
$0.00 |
| 90734 |
|
39 |
32 |
$0.00 |
| 1124F |
|
146 |
129 |
$0.00 |
| 1039F |
|
50 |
12 |
$0.00 |
| 99499 |
|
14 |
13 |
$0.00 |
| 90710 |
|
31 |
12 |
$0.00 |
| 87081 |
|
18 |
13 |
$0.00 |
| 3008F |
|
1,872 |
1,603 |
$0.00 |
| 3044F |
|
1,041 |
746 |
$0.00 |
| 3049F |
|
246 |
144 |
$0.00 |
| 4015F |
|
58 |
25 |
$0.00 |
| 1157F |
|
202 |
186 |
$0.00 |
| 96161 |
|
571 |
525 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
82 |
72 |
$0.00 |
| 76499 |
|
253 |
168 |
$0.00 |
| G0136 |
Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months |
32 |
30 |
$0.00 |
| 94760 |
|
162 |
117 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
59 |
12 |
$0.00 |
| T1029 |
Comprehensive environmental lead investigation, not including laboratory analysis, per dwelling |
14 |
14 |
$0.00 |
| 87430 |
|
13 |
13 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
15 |
15 |
$0.00 |
| 88142 |
|
14 |
13 |
$0.00 |
| 90620 |
|
31 |
26 |
$0.00 |
| 0501F |
|
14 |
12 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
13 |
13 |
$0.00 |
| 3061F |
|
13 |
12 |
$0.00 |
| 90697 |
|
32 |
12 |
$0.00 |