| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,679 |
16,035 |
$7.06M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18,668 |
13,940 |
$6.87M |
| D0140 |
Limited oral evaluation - problem focused |
6,400 |
4,530 |
$1.90M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,914 |
2,744 |
$1.22M |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,393 |
1,507 |
$700K |
| D0191 |
|
1,646 |
1,387 |
$616K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,335 |
986 |
$489K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,905 |
2,983 |
$337K |
| D0120 |
Periodic oral evaluation - established patient |
1,017 |
809 |
$233K |
| 99441 |
|
599 |
483 |
$225K |
| 0011A |
|
395 |
335 |
$163K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
4,218 |
3,019 |
$148K |
| 0012A |
|
421 |
301 |
$148K |
| D1354 |
|
4,466 |
578 |
$98K |
| D9995 |
|
470 |
361 |
$90K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
210 |
192 |
$83K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
473 |
228 |
$79K |
| 98966 |
|
156 |
105 |
$66K |
| 0064A |
|
137 |
130 |
$62K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
236 |
188 |
$61K |
| D1120 |
Prophylaxis - child |
635 |
421 |
$52K |
| 0071A |
|
93 |
91 |
$43K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
181 |
77 |
$39K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
89 |
77 |
$38K |
| D0220 |
Intraoral - periapical first radiographic image |
5,904 |
3,806 |
$37K |
| 0072A |
|
73 |
71 |
$35K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,909 |
1,141 |
$26K |
| 0002A |
|
48 |
48 |
$24K |
| 0001A |
|
47 |
47 |
$24K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
117 |
77 |
$23K |
| D9310 |
|
179 |
155 |
$19K |
| 92002 |
|
54 |
54 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
122 |
91 |
$16K |
| 99442 |
|
41 |
33 |
$14K |
| D1351 |
Sealant - per tooth |
3,029 |
366 |
$13K |
| D0274 |
Bitewings - four radiographic images |
1,207 |
730 |
$11K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
143 |
86 |
$10K |
| 0031A |
|
16 |
16 |
$8K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,356 |
1,058 |
$7K |
| 90686 |
|
659 |
500 |
$6K |
| D0145 |
Oral evaluation for a patient under three years of age |
29 |
27 |
$6K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
556 |
444 |
$3K |
| D0330 |
Panoramic radiographic image |
171 |
107 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
18 |
14 |
$2K |
| 90688 |
|
20 |
12 |
$1K |
| D0190 |
|
322 |
188 |
$1K |
| D1110 |
Prophylaxis - adult |
79 |
40 |
$1K |
| D9630 |
|
261 |
235 |
$958.00 |
| 90480 |
|
19 |
16 |
$719.02 |
| 80053 |
Comprehensive metabolic panel |
118 |
82 |
$710.35 |
| D0270 |
|
128 |
74 |
$444.00 |
| 80076 |
|
26 |
24 |
$133.56 |
| 81003 |
|
112 |
77 |
$131.94 |
| 82977 |
|
32 |
24 |
$117.60 |
| D0210 |
Intraoral - complete series of radiographic images |
18 |
17 |
$109.20 |
| 83735 |
|
14 |
14 |
$57.31 |
| 90658 |
|
287 |
225 |
$15.83 |
| 36415 |
Collection of venous blood by venipuncture |
111 |
81 |
$1.09 |
| D1320 |
|
245 |
183 |
$0.30 |
| 92015 |
Determination of refractive state |
171 |
135 |
$0.16 |
| G0008 |
Administration of influenza virus vaccine |
17 |
15 |
$0.05 |
| 87430 |
|
687 |
565 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
4,758 |
3,323 |
$0.00 |
| D0603 |
|
2,029 |
1,247 |
$0.00 |
| 90645 |
|
49 |
30 |
$0.00 |
| D1330 |
|
3,342 |
2,229 |
$0.00 |
| 90657 |
|
19 |
13 |
$0.00 |
| D3120 |
|
85 |
40 |
$0.00 |
| 99000 |
|
167 |
114 |
$0.00 |
| D1310 |
|
1,517 |
1,195 |
$0.00 |
| 90656 |
|
56 |
46 |
$0.00 |
| 92370 |
|
133 |
72 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
35 |
28 |
$0.00 |
| D9215 |
|
63 |
50 |
$0.00 |
| 90651 |
|
36 |
25 |
$0.00 |
| 90723 |
|
18 |
13 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
17 |
14 |
$0.00 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
121 |
105 |
$0.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,119 |
734 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
332 |
235 |
$0.00 |
| 91322 |
|
17 |
14 |
$0.00 |
| D0114 |
|
63 |
58 |
$0.00 |
| 90670 |
|
73 |
45 |
$0.00 |
| D9110 |
|
21 |
20 |
$0.00 |