| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
64,682 |
55,385 |
$420K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
19,422 |
16,728 |
$192K |
| D1110 |
Prophylaxis - adult |
3,984 |
3,161 |
$104K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,332 |
2,275 |
$63K |
| D1999 |
|
3,647 |
3,085 |
$53K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,574 |
4,818 |
$45K |
| 0012A |
|
1,350 |
1,138 |
$45K |
| D0120 |
Periodic oral evaluation - established patient |
3,303 |
2,551 |
$43K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,259 |
1,872 |
$42K |
| D0330 |
Panoramic radiographic image |
1,524 |
1,275 |
$40K |
| 0011A |
|
1,156 |
1,069 |
$39K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,596 |
2,056 |
$35K |
| D0272 |
Bitewings - two radiographic images |
2,685 |
2,160 |
$35K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,594 |
2,479 |
$31K |
| D1351 |
Sealant - per tooth |
2,307 |
286 |
$31K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,802 |
2,493 |
$30K |
| D1120 |
Prophylaxis - child |
1,527 |
1,193 |
$27K |
| 99441 |
|
13,809 |
12,163 |
$27K |
| 97802 |
|
403 |
325 |
$23K |
| 0064A |
|
319 |
315 |
$13K |
| 0071A |
|
243 |
236 |
$10K |
| 0072A |
|
235 |
230 |
$9K |
| 0013A |
|
218 |
218 |
$9K |
| 90670 |
|
1,856 |
1,717 |
$6K |
| 99442 |
|
5,028 |
4,594 |
$6K |
| 97803 |
|
296 |
274 |
$5K |
| 93000 |
|
1,201 |
1,173 |
$5K |
| 90651 |
|
2,062 |
1,892 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
382 |
377 |
$5K |
| 90715 |
|
1,139 |
1,024 |
$4K |
| 90686 |
|
1,452 |
1,366 |
$4K |
| 99242 |
|
93 |
91 |
$4K |
| 90656 |
|
292 |
224 |
$4K |
| 0004A |
|
110 |
109 |
$4K |
| 99205 |
Prolong outpt/office vis |
168 |
168 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
55 |
55 |
$4K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,270 |
1,994 |
$4K |
| 90716 |
|
1,171 |
1,100 |
$4K |
| 99051 |
|
377 |
333 |
$3K |
| 90707 |
|
1,097 |
1,036 |
$3K |
| 90658 |
|
1,303 |
1,152 |
$3K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
90 |
69 |
$3K |
| 90633 |
|
916 |
857 |
$3K |
| 0003A |
|
72 |
71 |
$3K |
| 90734 |
|
1,248 |
1,160 |
$3K |
| 96160 |
|
132 |
118 |
$3K |
| 76536 |
|
31 |
25 |
$3K |
| 0031A |
|
60 |
60 |
$2K |
| 90648 |
|
646 |
597 |
$2K |
| 0001A |
|
48 |
48 |
$2K |
| 90677 |
|
367 |
330 |
$2K |
| 90723 |
|
485 |
440 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,076 |
1,887 |
$2K |
| 0002A |
|
48 |
40 |
$1K |
| 94664 |
|
93 |
89 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
177 |
174 |
$1K |
| 90698 |
|
228 |
218 |
$816.00 |
| 94760 |
|
159 |
152 |
$807.30 |
| 90681 |
|
223 |
213 |
$786.00 |
| 90657 |
|
251 |
237 |
$752.00 |
| 90696 |
|
162 |
151 |
$568.00 |
| 90700 |
|
197 |
189 |
$558.00 |
| 90620 |
|
181 |
156 |
$476.00 |
| 90621 |
|
96 |
95 |
$465.62 |
| 90733 |
|
226 |
209 |
$453.00 |
| 99443 |
|
924 |
845 |
$376.71 |
| 90697 |
|
68 |
56 |
$293.39 |
| 90680 |
|
70 |
69 |
$268.00 |
| 90474 |
|
25 |
25 |
$231.60 |
| 90649 |
|
56 |
52 |
$192.00 |
| 90791 |
Psychiatric diagnostic evaluation |
144 |
137 |
$165.00 |
| D0140 |
Limited oral evaluation - problem focused |
13 |
13 |
$151.10 |
| 96127 |
|
1,460 |
1,367 |
$145.98 |
| 72100 |
|
29 |
29 |
$133.32 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
13 |
13 |
$94.13 |
| 90744 |
|
17 |
17 |
$64.00 |
| 71045 |
Radiologic examination, chest; single view |
95 |
88 |
$28.32 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
62 |
59 |
$20.48 |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
93 |
93 |
$15.00 |
| 3078F |
|
9,672 |
8,748 |
$0.00 |
| 1158F |
|
3,532 |
3,102 |
$0.00 |
| 4005F |
|
8,142 |
7,291 |
$0.00 |
| 4035F |
|
7,549 |
6,937 |
$0.00 |
| 0521F |
|
3,132 |
2,987 |
$0.00 |
| 1159F |
|
25,203 |
22,249 |
$0.00 |
| 1160F |
|
20,330 |
18,056 |
$0.00 |
| 3050F |
|
554 |
541 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
358 |
342 |
$0.00 |
| 3077F |
|
2,982 |
2,804 |
$0.00 |
| 4013F |
|
663 |
612 |
$0.00 |
| 99348 |
|
16 |
13 |
$0.00 |
| 99347 |
|
109 |
103 |
$0.00 |
| 3725F |
|
665 |
646 |
$0.00 |
| 80305 |
|
586 |
520 |
$0.00 |
| 3045F |
|
53 |
49 |
$0.00 |
| 3051F |
|
101 |
90 |
$0.00 |
| 99408 |
|
42 |
42 |
$0.00 |
| 87899 |
|
70 |
70 |
$0.00 |
| 3046F |
|
68 |
64 |
$0.00 |
| 2022F |
|
33 |
29 |
$0.00 |
| 80061 |
Lipid panel |
14 |
14 |
$0.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
25 |
13 |
$0.00 |
| 1030F |
|
1,509 |
1,363 |
$0.00 |
| 3080F |
|
1,284 |
1,221 |
$0.00 |
| 1170F |
|
3,709 |
3,255 |
$0.00 |
| 3008F |
|
18,701 |
16,481 |
$0.00 |
| 3074F |
|
13,425 |
11,978 |
$0.00 |
| 4010F |
|
3,435 |
3,183 |
$0.00 |
| 3044F |
|
3,177 |
2,929 |
$0.00 |
| 3079F |
|
7,438 |
6,920 |
$0.00 |
| 1111F |
|
1,789 |
1,679 |
$0.00 |
| 3060F |
|
366 |
351 |
$0.00 |
| 1125F |
|
3,671 |
3,476 |
$0.00 |
| 1157F |
|
2,494 |
2,122 |
$0.00 |
| 3048F |
|
2,089 |
2,006 |
$0.00 |
| 3075F |
|
2,189 |
2,098 |
$0.00 |
| 1126F |
|
7,232 |
6,666 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
27 |
26 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
325 |
317 |
$0.00 |
| 3017F |
|
1,162 |
970 |
$0.00 |
| 3061F |
|
1,772 |
1,727 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
166 |
156 |
$0.00 |
| 2010F |
|
70 |
64 |
$0.00 |
| 3049F |
|
971 |
957 |
$0.00 |
| 1101F |
|
158 |
155 |
$0.00 |
| 99243 |
|
28 |
28 |
$0.00 |
| 2001F |
|
755 |
690 |
$0.00 |
| 1036F |
|
359 |
321 |
$0.00 |
| 3351F |
|
539 |
529 |
$0.00 |
| 82378 |
|
12 |
12 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
79 |
78 |
$0.00 |
| 3014F |
|
112 |
109 |
$0.00 |
| 3011F |
|
60 |
60 |
$0.00 |
| 73560 |
|
14 |
14 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
13 |
13 |
$0.00 |
| 85027 |
|
28 |
28 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
27 |
27 |
$0.00 |
| 4210F |
|
49 |
45 |
$0.00 |
| 99368 |
|
50 |
50 |
$0.00 |
| 96150 |
|
79 |
79 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
152 |
150 |
$0.00 |
| 82043 |
|
12 |
12 |
$0.00 |
| 1022F |
|
16 |
16 |
$0.00 |
| 90480 |
|
13 |
13 |
$0.00 |
| 81005 |
|
18 |
18 |
$0.00 |
| 91301 |
|
14 |
14 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
33 |
19 |
$0.00 |
| 2000F |
|
20 |
20 |
$0.00 |