| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
769,730 |
694,714 |
$3.89M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,154 |
5,980 |
$553K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,499 |
2,777 |
$359K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,224 |
2,778 |
$294K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,377 |
1,979 |
$209K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,788 |
2,236 |
$206K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,140 |
2,217 |
$196K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13,522 |
11,039 |
$136K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
6,962 |
5,568 |
$125K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,967 |
2,158 |
$83K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,470 |
1,124 |
$70K |
| 0001A |
|
1,086 |
906 |
$52K |
| 0002A |
|
998 |
830 |
$50K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
1,322 |
1,004 |
$49K |
| D0145 |
Oral evaluation for a patient under three years of age |
1,471 |
1,020 |
$32K |
| D0120 |
Periodic oral evaluation - established patient |
1,046 |
1,042 |
$30K |
| 96127 |
|
6,623 |
5,027 |
$27K |
| 90651 |
|
1,458 |
1,220 |
$25K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
370 |
288 |
$22K |
| 92587 |
|
7,438 |
6,165 |
$20K |
| D1120 |
Prophylaxis - child |
618 |
615 |
$19K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,032 |
1,026 |
$19K |
| 99502 |
|
322 |
311 |
$18K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,599 |
1,905 |
$17K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
637 |
482 |
$17K |
| 90474 |
|
1,841 |
1,289 |
$17K |
| D1206 |
Topical application of fluoride varnish |
1,476 |
1,023 |
$14K |
| D1110 |
Prophylaxis - adult |
349 |
348 |
$14K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
521 |
341 |
$13K |
| 86480 |
|
978 |
552 |
$13K |
| 36415 |
Collection of venous blood by venipuncture |
5,428 |
4,080 |
$13K |
| T1002 |
Rn services, up to 15 minutes |
682 |
414 |
$13K |
| 0071A |
|
360 |
216 |
$12K |
| 0072A |
|
324 |
195 |
$12K |
| 90734 |
|
800 |
767 |
$12K |
| 90686 |
|
6,428 |
5,293 |
$12K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
241 |
231 |
$12K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
190 |
109 |
$10K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
86 |
58 |
$9K |
| 96160 |
|
3,533 |
2,792 |
$8K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
670 |
528 |
$8K |
| 90715 |
|
1,116 |
930 |
$8K |
| 90621 |
|
262 |
258 |
$7K |
| 81003 |
|
2,959 |
2,006 |
$7K |
| 90698 |
|
1,140 |
968 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,164 |
3,227 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
171 |
123 |
$5K |
| 90716 |
|
1,310 |
1,049 |
$5K |
| 0053A |
|
60 |
45 |
$3K |
| D0330 |
Panoramic radiographic image |
76 |
71 |
$3K |
| 90480 |
|
209 |
79 |
$3K |
| 0003A |
|
83 |
53 |
$3K |
| 90707 |
|
1,079 |
885 |
$3K |
| 99245 |
|
12 |
12 |
$2K |
| 96161 |
|
1,948 |
1,083 |
$2K |
| 99492 |
|
12 |
12 |
$2K |
| 99493 |
|
15 |
15 |
$2K |
| 0054A |
|
34 |
27 |
$2K |
| 85018 |
|
1,988 |
1,660 |
$2K |
| 83655 |
|
1,458 |
1,034 |
$1K |
| 0031A |
|
22 |
22 |
$1K |
| 0124A |
|
62 |
25 |
$1K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
17 |
12 |
$1K |
| D0274 |
Bitewings - four radiographic images |
48 |
45 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
183 |
80 |
$1K |
| 82950 |
|
184 |
155 |
$1K |
| 81025 |
|
195 |
131 |
$1K |
| 0012A |
|
17 |
17 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,104 |
1,406 |
$945.22 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,882 |
1,322 |
$940.98 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,092 |
1,404 |
$913.32 |
| 90670 |
|
2,365 |
1,686 |
$825.66 |
| D0272 |
Bitewings - two radiographic images |
43 |
41 |
$793.65 |
| D0220 |
Intraoral - periapical first radiographic image |
44 |
43 |
$721.60 |
| 90672 |
|
225 |
176 |
$595.68 |
| 87210 |
|
134 |
104 |
$480.15 |
| 82120 |
|
131 |
104 |
$430.20 |
| 90473 |
|
123 |
99 |
$407.40 |
| 97803 |
|
14 |
13 |
$405.80 |
| 80061 |
Lipid panel |
994 |
733 |
$398.83 |
| 0011A |
|
24 |
24 |
$384.92 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
39 |
33 |
$359.17 |
| 90619 |
|
879 |
649 |
$320.07 |
| 90656 |
|
122 |
109 |
$304.00 |
| 90677 |
|
307 |
195 |
$268.63 |
| 80053 |
Comprehensive metabolic panel |
749 |
530 |
$236.56 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,240 |
837 |
$179.37 |
| 90633 |
|
1,062 |
885 |
$161.56 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,083 |
725 |
$158.86 |
| 86592 |
|
1,617 |
1,138 |
$118.31 |
| 82947 |
|
33 |
26 |
$102.67 |
| 90680 |
|
1,888 |
1,209 |
$92.44 |
| 86803 |
|
833 |
510 |
$90.75 |
| 96381 |
|
17 |
14 |
$88.80 |
| 87340 |
|
1,020 |
717 |
$82.81 |
| 83020 |
|
289 |
162 |
$79.90 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
320 |
164 |
$66.08 |
| 86850 |
|
609 |
412 |
$29.62 |
| 99173 |
|
932 |
817 |
$27.27 |
| 86787 |
|
272 |
149 |
$16.38 |
| 86900 |
|
646 |
449 |
$11.37 |
| 86280 |
|
59 |
59 |
$9.67 |
| 86901 |
|
645 |
448 |
$7.58 |
| 99177 |
|
6,597 |
5,404 |
$0.00 |
| 91300 |
|
2,239 |
1,562 |
$0.00 |
| 81443 |
|
152 |
115 |
$0.00 |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
243 |
156 |
$0.00 |
| 90685 |
|
163 |
163 |
$0.00 |
| 91312 |
|
71 |
27 |
$0.00 |
| LU283 |
|
14 |
14 |
$0.00 |
| 90697 |
|
990 |
482 |
$0.00 |
| 91307 |
|
838 |
469 |
$0.00 |
| 86762 |
|
901 |
650 |
$0.00 |
| 90744 |
|
371 |
340 |
$0.00 |
| 90696 |
|
91 |
85 |
$0.00 |
| 90620 |
|
428 |
283 |
$0.00 |
| 91305 |
|
261 |
196 |
$0.00 |
| 90660 |
|
18 |
16 |
$0.00 |
| 90723 |
|
55 |
41 |
$0.00 |
| 91301 |
|
59 |
59 |
$0.00 |
| 90647 |
|
28 |
17 |
$0.00 |
| 90381 |
|
80 |
30 |
$0.00 |
| 91303 |
|
22 |
22 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
61 |
47 |
$0.00 |