| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,567 |
5,255 |
$81K |
| T2022 |
Case management, per month |
424 |
402 |
$65K |
| D1206 |
Topical application of fluoride varnish |
4,151 |
3,870 |
$64K |
| 90739 |
|
465 |
463 |
$56K |
| 90715 |
|
2,439 |
2,408 |
$53K |
| 90707 |
|
735 |
729 |
$41K |
| D1330 |
|
3,246 |
3,006 |
$38K |
| 90716 |
|
531 |
528 |
$33K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,656 |
2,573 |
$32K |
| D0190 |
|
2,816 |
2,581 |
$29K |
| 91320 |
|
187 |
186 |
$19K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,138 |
1,055 |
$17K |
| 90651 |
|
663 |
658 |
$17K |
| 90686 |
|
968 |
960 |
$14K |
| D0191 |
|
1,309 |
1,269 |
$13K |
| 90713 |
|
486 |
480 |
$12K |
| 90636 |
|
96 |
94 |
$9K |
| 90734 |
|
542 |
539 |
$9K |
| 90682 |
|
123 |
120 |
$8K |
| 86580 |
|
1,298 |
1,157 |
$7K |
| 90710 |
|
563 |
561 |
$6K |
| 90688 |
|
381 |
372 |
$6K |
| 90480 |
|
152 |
148 |
$6K |
| 90633 |
|
402 |
400 |
$4K |
| 90746 |
|
64 |
62 |
$4K |
| 90670 |
|
202 |
199 |
$4K |
| 90744 |
|
231 |
227 |
$3K |
| 90696 |
|
195 |
195 |
$2K |
| 90672 |
|
112 |
112 |
$2K |
| 90685 |
|
56 |
56 |
$715.23 |
| D9999 |
Unspecified adjunctive procedure, by report |
18 |
18 |
$694.98 |
| 90656 |
|
32 |
32 |
$609.57 |
| 90723 |
|
60 |
60 |
$495.94 |
| 90621 |
|
20 |
20 |
$449.74 |
| 90698 |
|
43 |
43 |
$364.56 |
| 99429 |
|
18 |
13 |
$358.54 |
| 90619 |
|
12 |
12 |
$236.28 |