| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31,128 |
27,742 |
$2.05M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,615 |
7,200 |
$703K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,441 |
4,083 |
$388K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,903 |
2,884 |
$245K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,352 |
2,340 |
$175K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,710 |
1,702 |
$129K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,742 |
2,590 |
$110K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,527 |
2,375 |
$106K |
| 87428 |
|
1,536 |
1,476 |
$86K |
| 91300 |
|
3,054 |
1,837 |
$52K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,835 |
3,693 |
$47K |
| 85018 |
|
6,249 |
6,173 |
$45K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15,032 |
14,680 |
$38K |
| 99460 |
|
114 |
112 |
$37K |
| 90688 |
|
4,764 |
4,656 |
$36K |
| D0140 |
Limited oral evaluation - problem focused |
245 |
236 |
$27K |
| 81000 |
|
1,867 |
1,742 |
$21K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
282 |
270 |
$20K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,024 |
985 |
$19K |
| 91307 |
|
821 |
512 |
$16K |
| 81025 |
|
1,069 |
1,003 |
$14K |
| 90715 |
|
733 |
718 |
$8K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
6,843 |
6,682 |
$8K |
| 90677 |
|
867 |
859 |
$8K |
| 83655 |
|
2,488 |
2,468 |
$7K |
| 91305 |
|
372 |
226 |
$7K |
| 90651 |
|
1,244 |
1,224 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
297 |
281 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
556 |
533 |
$5K |
| D7140 |
Extraction, erupted tooth or exposed root |
218 |
129 |
$5K |
| 90686 |
|
732 |
716 |
$5K |
| 99051 |
|
742 |
699 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
1,151 |
1,016 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
42 |
41 |
$3K |
| 87420 |
|
144 |
142 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
33 |
31 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
45 |
41 |
$3K |
| 90834 |
Psychotherapy, 45 minutes with patient |
28 |
25 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
365 |
342 |
$2K |
| 90656 |
|
551 |
551 |
$2K |
| 90734 |
|
294 |
281 |
$2K |
| 90716 |
|
341 |
337 |
$2K |
| 90698 |
|
1,332 |
1,312 |
$2K |
| 91312 |
|
109 |
76 |
$1K |
| 82962 |
|
335 |
328 |
$1K |
| D0274 |
Bitewings - four radiographic images |
43 |
42 |
$981.12 |
| 90619 |
|
608 |
604 |
$946.25 |
| 90670 |
|
2,238 |
2,191 |
$932.92 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$906.70 |
| 90474 |
|
1,763 |
1,733 |
$877.89 |
| 90620 |
|
113 |
113 |
$773.83 |
| 90696 |
|
213 |
213 |
$750.90 |
| 91303 |
|
40 |
28 |
$709.76 |
| 90633 |
|
767 |
758 |
$662.06 |
| 90685 |
|
139 |
139 |
$640.82 |
| D1120 |
Prophylaxis - child |
26 |
26 |
$620.80 |
| D0230 |
Intraoral - periapical each additional radiographic image |
106 |
61 |
$584.06 |
| 0071A |
|
349 |
226 |
$560.16 |
| 90697 |
|
1,105 |
1,087 |
$487.99 |
| 90744 |
|
486 |
467 |
$472.71 |
| 82274 |
|
29 |
29 |
$458.12 |
| 99442 |
|
46 |
39 |
$423.89 |
| 90680 |
|
1,218 |
1,188 |
$330.25 |
| 90710 |
|
232 |
232 |
$328.49 |
| 0072A |
|
313 |
211 |
$320.08 |
| 99174 |
|
292 |
290 |
$290.91 |
| 90672 |
|
65 |
58 |
$277.02 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
129 |
127 |
$232.00 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$214.44 |
| 0002A |
|
1,203 |
798 |
$176.81 |
| 0003A |
|
234 |
154 |
$160.03 |
| 90480 |
|
15 |
15 |
$124.60 |
| 96127 |
|
87 |
87 |
$107.33 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
29 |
28 |
$79.39 |
| 0001A |
|
1,355 |
879 |
$73.91 |
| 90707 |
|
248 |
244 |
$39.73 |
| 0124A |
|
109 |
76 |
$37.62 |
| 96161 |
|
54 |
54 |
$4.34 |
| 90681 |
|
567 |
559 |
$0.04 |
| 90473 |
|
37 |
37 |
$0.00 |
| 82948 |
|
14 |
14 |
$0.00 |
| 0054A |
|
19 |
14 |
$0.00 |
| 0053A |
|
42 |
25 |
$0.00 |
| 90700 |
|
16 |
16 |
$0.00 |
| 99462 |
|
16 |
13 |
$0.00 |
| 3008F |
|
12 |
12 |
$0.00 |
| 0031A |
|
39 |
28 |
$0.00 |
| D1330 |
|
17 |
16 |
$0.00 |