| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63,019 |
49,833 |
$3.05M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27,782 |
22,398 |
$1.84M |
| T1015 |
Clinic visit/encounter, all-inclusive |
110,952 |
77,147 |
$1.24M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
6,887 |
5,875 |
$547K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
6,928 |
5,874 |
$508K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,102 |
3,597 |
$321K |
| 59425 |
|
6,283 |
3,620 |
$292K |
| 90837 |
Psychotherapy, 53 minutes with patient |
3,438 |
1,692 |
$277K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30,066 |
23,418 |
$270K |
| D1351 |
Sealant - per tooth |
16,334 |
3,038 |
$257K |
| D9999 |
Unspecified adjunctive procedure, by report |
33,056 |
22,661 |
$231K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15,616 |
11,568 |
$217K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
5,660 |
4,668 |
$215K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
6,557 |
4,717 |
$167K |
| 59426 |
|
2,695 |
1,027 |
$165K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,776 |
1,215 |
$164K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,753 |
1,448 |
$162K |
| D1206 |
Topical application of fluoride varnish |
12,232 |
8,946 |
$143K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
4,805 |
1,193 |
$141K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,738 |
1,546 |
$134K |
| D0330 |
Panoramic radiographic image |
3,733 |
2,574 |
$133K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,466 |
1,945 |
$128K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,549 |
1,358 |
$120K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,598 |
1,245 |
$114K |
| D0140 |
Limited oral evaluation - problem focused |
4,096 |
3,067 |
$94K |
| D0120 |
Periodic oral evaluation - established patient |
5,862 |
4,102 |
$91K |
| D1110 |
Prophylaxis - adult |
2,740 |
1,875 |
$89K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,549 |
2,021 |
$77K |
| D0274 |
Bitewings - four radiographic images |
3,580 |
2,677 |
$68K |
| D1120 |
Prophylaxis - child |
3,109 |
2,173 |
$67K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,898 |
1,004 |
$65K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
8,719 |
7,198 |
$57K |
| 99381 |
|
919 |
769 |
$48K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,088 |
3,809 |
$46K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,278 |
684 |
$44K |
| D0210 |
Intraoral - complete series of radiographic images |
2,027 |
1,570 |
$39K |
| 90686 |
|
2,831 |
2,199 |
$34K |
| 87110 |
|
5,072 |
3,797 |
$32K |
| V2020 |
Frames, purchases |
1,721 |
1,442 |
$29K |
| 36416 |
|
13,100 |
10,801 |
$28K |
| 92015 |
Determination of refractive state |
2,176 |
1,850 |
$28K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,255 |
902 |
$26K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
344 |
218 |
$23K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,075 |
874 |
$23K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
549 |
482 |
$22K |
| D0220 |
Intraoral - periapical first radiographic image |
2,847 |
2,103 |
$22K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,915 |
1,591 |
$22K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,006 |
1,679 |
$21K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,121 |
1,576 |
$19K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
823 |
566 |
$17K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
585 |
458 |
$17K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
280 |
239 |
$15K |
| 90715 |
|
759 |
605 |
$12K |
| 90656 |
|
1,122 |
987 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
531 |
472 |
$10K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
62 |
46 |
$9K |
| 0071A |
|
260 |
250 |
$9K |
| 0072A |
|
233 |
231 |
$8K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
678 |
463 |
$8K |
| 96158 |
|
235 |
152 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
106 |
89 |
$8K |
| 85018 |
|
4,293 |
3,662 |
$8K |
| 0081A |
|
213 |
202 |
$7K |
| 0124A |
|
248 |
203 |
$7K |
| D0272 |
Bitewings - two radiographic images |
556 |
403 |
$7K |
| 99383 |
|
68 |
64 |
$6K |
| 0004A |
|
173 |
165 |
$6K |
| 87210 |
|
1,314 |
1,047 |
$5K |
| 0082A |
|
127 |
127 |
$5K |
| 90474 |
|
336 |
279 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
140 |
114 |
$3K |
| 96156 |
|
85 |
65 |
$2K |
| 99385 |
|
31 |
25 |
$2K |
| D4910 |
|
46 |
41 |
$2K |
| J3490 |
Unclassified drugs |
135 |
68 |
$2K |
| 90480 |
|
116 |
59 |
$2K |
| 0001A |
|
52 |
51 |
$2K |
| 90651 |
|
440 |
301 |
$2K |
| 99215 |
Prolong outpt/office vis |
26 |
25 |
$1K |
| 99382 |
|
15 |
14 |
$1K |
| 99386 |
|
13 |
12 |
$1K |
| 81002 |
|
989 |
711 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
30 |
28 |
$956.40 |
| 90670 |
|
5,249 |
4,418 |
$838.69 |
| 0002A |
|
30 |
29 |
$781.41 |
| 59025 |
Fetal non-stress test |
19 |
12 |
$667.23 |
| 90734 |
|
292 |
201 |
$604.96 |
| D0145 |
Oral evaluation for a patient under three years of age |
27 |
13 |
$603.50 |
| 0083A |
|
14 |
14 |
$520.94 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,583 |
1,231 |
$510.62 |
| 0013A |
|
13 |
13 |
$483.73 |
| 0173A |
|
14 |
12 |
$483.73 |
| 81001 |
|
255 |
194 |
$415.15 |
| 0154A |
|
23 |
12 |
$409.31 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
74 |
60 |
$289.37 |
| 80061 |
Lipid panel |
44 |
36 |
$216.93 |
| 84443 |
Thyroid stimulating hormone (TSH) |
19 |
14 |
$201.60 |
| 80053 |
Comprehensive metabolic panel |
39 |
32 |
$146.72 |
| 3044F |
|
30 |
24 |
$120.00 |
| 84439 |
|
19 |
14 |
$117.26 |
| 90723 |
|
3,257 |
2,814 |
$85.26 |
| 90633 |
|
2,986 |
2,487 |
$37.99 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
233 |
179 |
$21.70 |
| 90688 |
|
7,515 |
6,287 |
$10.90 |
| 90685 |
|
552 |
500 |
$3.78 |
| 90647 |
|
2,401 |
2,017 |
$3.19 |
| 90698 |
|
1,269 |
1,067 |
$3.11 |
| 90680 |
|
1,358 |
1,142 |
$2.34 |
| 90681 |
|
1,226 |
1,017 |
$1.54 |
| 90707 |
|
332 |
263 |
$0.21 |
| 90744 |
|
126 |
98 |
$0.18 |
| 90716 |
|
271 |
215 |
$0.14 |
| 90710 |
|
133 |
100 |
$0.03 |
| 91300 |
|
437 |
410 |
$0.00 |
| 90671 |
|
661 |
503 |
$0.00 |
| 3078F |
|
77 |
69 |
$0.00 |
| 91308 |
|
385 |
362 |
$0.00 |
| 90700 |
|
98 |
81 |
$0.00 |
| 91312 |
|
241 |
201 |
$0.00 |
| 3077F |
|
17 |
14 |
$0.00 |
| 91301 |
|
49 |
47 |
$0.00 |
| 91319 |
|
25 |
14 |
$0.00 |
| 91307 |
|
637 |
572 |
$0.00 |
| 90677 |
|
556 |
506 |
$0.00 |
| D0602 |
|
107 |
104 |
$0.00 |
| 91317 |
|
64 |
38 |
$0.00 |
| 3061F |
|
13 |
12 |
$0.00 |
| D0601 |
|
214 |
210 |
$0.00 |
| 3074F |
|
107 |
99 |
$0.00 |
| 91315 |
|
23 |
12 |
$0.00 |
| D0603 |
|
106 |
105 |
$0.00 |
| 3048F |
|
28 |
26 |
$0.00 |
| 3079F |
|
43 |
39 |
$0.00 |
| 90696 |
|
16 |
12 |
$0.00 |