| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5102 |
Day care services, adult; per diem |
65,608 |
6,654 |
$12.00M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27,975 |
19,657 |
$2.85M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18,239 |
12,815 |
$2.06M |
| 90832 |
Psychotherapy, 30 minutes with patient |
11,711 |
6,128 |
$1.55M |
| 90834 |
Psychotherapy, 45 minutes with patient |
8,921 |
4,565 |
$1.26M |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
6,370 |
4,919 |
$376K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,256 |
2,476 |
$291K |
| D1110 |
Prophylaxis - adult |
2,069 |
1,373 |
$146K |
| 90791 |
Psychiatric diagnostic evaluation |
643 |
467 |
$97K |
| D0210 |
Intraoral - complete series of radiographic images |
1,390 |
642 |
$64K |
| 3008F |
|
14,744 |
11,848 |
$61K |
| D0120 |
Periodic oral evaluation - established patient |
1,989 |
988 |
$55K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
472 |
350 |
$54K |
| D7311 |
|
343 |
316 |
$46K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
523 |
275 |
$39K |
| D0220 |
Intraoral - periapical first radiographic image |
2,330 |
1,784 |
$36K |
| D0140 |
Limited oral evaluation - problem focused |
998 |
563 |
$35K |
| D0274 |
Bitewings - four radiographic images |
1,098 |
530 |
$32K |
| 99441 |
|
536 |
249 |
$29K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
424 |
226 |
$22K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
669 |
497 |
$22K |
| 99215 |
Prolong outpt/office vis |
183 |
154 |
$19K |
| 99442 |
|
299 |
151 |
$18K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,025 |
606 |
$17K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
134 |
71 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
124 |
83 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
565 |
561 |
$9K |
| 0001F |
|
13,716 |
11,723 |
$9K |
| D1320 |
|
512 |
470 |
$7K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
62 |
51 |
$6K |
| 90836 |
|
81 |
73 |
$5K |
| 0012A |
|
234 |
234 |
$3K |
| 99051 |
|
445 |
274 |
$3K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
13 |
13 |
$2K |
| 90686 |
|
124 |
124 |
$2K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
23 |
12 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
17 |
12 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
1,226 |
1,199 |
$2K |
| 0011A |
|
224 |
220 |
$2K |
| D0270 |
|
103 |
66 |
$2K |
| D0470 |
|
22 |
12 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
26 |
14 |
$2K |
| 99000 |
|
1,123 |
1,046 |
$2K |
| 90674 |
|
53 |
53 |
$1K |
| 0013A |
|
40 |
40 |
$1K |
| 90658 |
|
75 |
75 |
$1K |
| 86803 |
|
101 |
92 |
$793.12 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
52 |
52 |
$710.82 |
| 90682 |
|
18 |
17 |
$700.64 |
| 0134A |
|
13 |
13 |
$500.13 |
| 86704 |
|
43 |
43 |
$323.76 |
| 86706 |
|
44 |
44 |
$312.42 |
| 99406 |
|
45 |
45 |
$229.94 |
| 87340 |
|
43 |
43 |
$180.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$172.29 |
| 88142 |
|
32 |
32 |
$170.92 |
| A4614 |
Peak expiratory flow rate meter, hand held |
13 |
12 |
$5.05 |
| D0603 |
|
112 |
112 |
$0.00 |
| D0180 |
|
12 |
12 |
$0.00 |