| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
56,634 |
38,703 |
$31.95M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,900 |
2,599 |
$790K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,676 |
1,521 |
$710K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,243 |
1,017 |
$519K |
| W0037 |
|
12,808 |
12,808 |
$267K |
| D0140 |
Limited oral evaluation - problem focused |
407 |
385 |
$219K |
| 0001A |
|
454 |
441 |
$203K |
| 0002A |
|
396 |
392 |
$190K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
432 |
410 |
$164K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
354 |
326 |
$145K |
| 0011A |
|
236 |
232 |
$106K |
| 0012A |
|
208 |
206 |
$96K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,447 |
1,237 |
$82K |
| 0071A |
|
176 |
165 |
$81K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
182 |
163 |
$81K |
| 0072A |
|
140 |
134 |
$76K |
| 0064A |
|
128 |
127 |
$61K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
137 |
133 |
$46K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
96 |
85 |
$44K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
69 |
69 |
$35K |
| D1206 |
Topical application of fluoride varnish |
91 |
91 |
$32K |
| 90837 |
Psychotherapy, 53 minutes with patient |
78 |
53 |
$31K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
351 |
311 |
$30K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
756 |
640 |
$30K |
| 0052A |
|
46 |
46 |
$28K |
| 85027 |
|
1,970 |
1,832 |
$25K |
| 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 |
388 |
363 |
$24K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
446 |
380 |
$23K |
| 99215 |
Prolong outpt/office vis |
49 |
47 |
$21K |
| 0054A |
|
48 |
40 |
$20K |
| 0004A |
|
77 |
48 |
$20K |
| 0051A |
|
39 |
37 |
$20K |
| 87081 |
|
464 |
441 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
56 |
47 |
$15K |
| D0220 |
Intraoral - periapical first radiographic image |
216 |
211 |
$15K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,479 |
1,211 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
26 |
26 |
$14K |
| D7140 |
Extraction, erupted tooth or exposed root |
79 |
59 |
$12K |
| 86703 |
|
468 |
404 |
$11K |
| 90686 |
|
773 |
670 |
$10K |
| 80053 |
Comprehensive metabolic panel |
1,840 |
1,716 |
$9K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,369 |
1,287 |
$8K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
36 |
30 |
$7K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
17 |
13 |
$7K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
15 |
15 |
$7K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
994 |
938 |
$6K |
| D0274 |
Bitewings - four radiographic images |
59 |
59 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
19 |
13 |
$5K |
| 92002 |
|
16 |
15 |
$5K |
| 80061 |
Lipid panel |
886 |
837 |
$4K |
| 84443 |
Thyroid stimulating hormone (TSH) |
998 |
953 |
$4K |
| 86592 |
|
366 |
322 |
$3K |
| 92015 |
Determination of refractive state |
258 |
222 |
$3K |
| D1110 |
Prophylaxis - adult |
60 |
59 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
370 |
345 |
$3K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
742 |
679 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,364 |
743 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
751 |
708 |
$2K |
| 86769 |
|
35 |
32 |
$2K |
| 84703 |
|
300 |
262 |
$2K |
| 81001 |
|
819 |
744 |
$2K |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$1K |
| 80306 |
|
56 |
45 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
38 |
38 |
$1K |
| 87088 |
|
500 |
431 |
$1K |
| 83735 |
|
593 |
569 |
$1K |
| 86141 |
|
122 |
117 |
$1K |
| 90723 |
|
262 |
229 |
$1K |
| 86780 |
|
367 |
323 |
$679.72 |
| 82607 |
|
230 |
216 |
$641.21 |
| 81003 |
|
637 |
587 |
$640.19 |
| 82570 |
|
157 |
150 |
$640.00 |
| D0270 |
|
28 |
28 |
$640.00 |
| 80074 |
|
287 |
260 |
$566.63 |
| 84439 |
|
843 |
811 |
$528.74 |
| 87807 |
|
175 |
167 |
$519.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
94 |
87 |
$519.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
469 |
395 |
$175.45 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
946 |
678 |
$31.98 |
| 93000 |
|
30 |
27 |
$18.71 |
| 86593 |
|
369 |
323 |
$13.20 |
| 36415 |
Collection of venous blood by venipuncture |
3,079 |
2,656 |
$7.71 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
201 |
175 |
$6.87 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
186 |
167 |
$4.24 |
| 82746 |
|
135 |
130 |
$1.18 |
| 90647 |
|
246 |
216 |
$0.00 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
16 |
12 |
$0.00 |
| 91301 |
|
514 |
496 |
$0.00 |
| 87077 |
|
438 |
418 |
$0.00 |
| 90680 |
|
17 |
17 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
180 |
67 |
$0.00 |
| 91306 |
|
114 |
114 |
$0.00 |
| 87428 |
|
59 |
53 |
$0.00 |
| 82043 |
|
156 |
149 |
$0.00 |
| 90474 |
|
29 |
27 |
$0.00 |
| 91305 |
|
171 |
149 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
57 |
57 |
$0.00 |
| 90651 |
|
92 |
56 |
$0.00 |
| 91307 |
|
330 |
287 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 1111F |
|
33 |
33 |
$0.00 |
| 90694 |
|
12 |
12 |
$0.00 |
| 90674 |
|
17 |
17 |
$0.00 |
| 86803 |
|
18 |
13 |
$0.00 |
| 90480 |
|
13 |
13 |
$0.00 |
| 90670 |
|
326 |
284 |
$0.00 |
| 90715 |
|
89 |
64 |
$0.00 |
| 90633 |
|
64 |
57 |
$0.00 |
| 91322 |
|
13 |
13 |
$0.00 |
| 90710 |
|
89 |
82 |
$0.00 |
| 91300 |
|
879 |
771 |
$0.00 |
| 83540 |
|
14 |
13 |
$0.00 |
| 87186 |
|
31 |
28 |
$0.00 |
| 83655 |
|
12 |
12 |
$0.00 |
| 90734 |
|
94 |
67 |
$0.00 |
| 0502F |
|
51 |
26 |
$0.00 |
| 90672 |
|
14 |
13 |
$0.00 |