| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
37,703 |
22,512 |
$4.09M |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,889 |
2,102 |
$659K |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,458 |
2,386 |
$514K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,404 |
1,417 |
$298K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,199 |
1,408 |
$225K |
| 99442 |
|
2,186 |
1,398 |
$220K |
| D0120 |
Periodic oral evaluation - established patient |
5,674 |
2,091 |
$208K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,930 |
1,250 |
$192K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,246 |
5,158 |
$176K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,429 |
914 |
$147K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,125 |
791 |
$103K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
747 |
554 |
$86K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
640 |
468 |
$72K |
| D1110 |
Prophylaxis - adult |
1,040 |
889 |
$63K |
| 99443 |
|
468 |
269 |
$54K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
954 |
435 |
$49K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,020 |
338 |
$47K |
| 97803 |
|
733 |
728 |
$35K |
| D0220 |
Intraoral - periapical first radiographic image |
2,135 |
1,909 |
$31K |
| D0274 |
Bitewings - four radiographic images |
1,318 |
1,252 |
$30K |
| D1208 |
Topical application of fluoride, excluding varnish |
886 |
614 |
$28K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,964 |
1,917 |
$26K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,952 |
1,609 |
$21K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
190 |
132 |
$20K |
| 90686 |
|
3,115 |
3,112 |
$19K |
| 36415 |
Collection of venous blood by venipuncture |
7,269 |
6,658 |
$17K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
147 |
72 |
$16K |
| 99173 |
|
3,872 |
3,866 |
$15K |
| D2140 |
|
164 |
78 |
$14K |
| D0140 |
Limited oral evaluation - problem focused |
247 |
96 |
$13K |
| D1120 |
Prophylaxis - child |
334 |
333 |
$11K |
| 0012A |
|
286 |
286 |
$10K |
| 90461 |
|
268 |
267 |
$9K |
| 0011A |
|
272 |
272 |
$9K |
| 99441 |
|
123 |
106 |
$7K |
| 92551 |
|
1,011 |
1,010 |
$7K |
| 99401 |
|
244 |
244 |
$6K |
| 1000F |
|
3,190 |
3,104 |
$5K |
| 0002A |
|
129 |
129 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
63 |
31 |
$5K |
| 0001A |
|
121 |
121 |
$5K |
| 86703 |
|
557 |
557 |
$5K |
| 90750 |
|
31 |
31 |
$5K |
| 99385 |
|
40 |
26 |
$4K |
| 99215 |
Prolong outpt/office vis |
29 |
14 |
$4K |
| D1330 |
|
51 |
51 |
$4K |
| 0064A |
|
94 |
94 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
15 |
14 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
30 |
15 |
$3K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
33 |
32 |
$2K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
37 |
37 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
221 |
221 |
$2K |
| 0071A |
|
45 |
43 |
$2K |
| 97802 |
|
29 |
29 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
30 |
26 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
85 |
85 |
$1K |
| D1999 |
|
105 |
80 |
$1K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
148 |
142 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
43 |
41 |
$1K |
| 90656 |
|
56 |
56 |
$1K |
| 96161 |
|
985 |
974 |
$1K |
| 81000 |
|
364 |
218 |
$586.51 |
| 0031A |
|
13 |
13 |
$373.66 |
| 11721 |
|
13 |
13 |
$369.02 |
| 81025 |
|
41 |
40 |
$243.78 |
| 90670 |
|
12 |
12 |
$210.00 |
| 99000 |
|
5,720 |
5,609 |
$10.18 |
| S4993 |
Contraceptive pills for birth control |
12 |
12 |
$1.78 |
| 91306 |
|
53 |
53 |
$0.00 |
| 91301 |
|
225 |
223 |
$0.00 |
| 91300 |
|
129 |
105 |
$0.00 |
| 90649 |
|
14 |
14 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |