| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27,674 |
25,493 |
$1.02M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,301 |
8,294 |
$490K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
10,297 |
9,633 |
$297K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,196 |
4,644 |
$281K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,964 |
3,711 |
$243K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
6,425 |
5,963 |
$170K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,351 |
2,203 |
$140K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,428 |
1,320 |
$86K |
| 99215 |
Prolong outpt/office vis |
1,149 |
988 |
$80K |
| 99460 |
|
1,499 |
1,364 |
$59K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,214 |
1,096 |
$54K |
| 99051 |
|
4,855 |
4,633 |
$36K |
| D1120 |
Prophylaxis - child |
672 |
670 |
$31K |
| 99173 |
|
609 |
542 |
$28K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,164 |
2,049 |
$27K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
776 |
772 |
$20K |
| 90837 |
Psychotherapy, 53 minutes with patient |
478 |
299 |
$17K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
655 |
497 |
$17K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
810 |
796 |
$14K |
| 99245 |
|
165 |
136 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
186 |
175 |
$12K |
| D1206 |
Topical application of fluoride varnish |
757 |
754 |
$11K |
| 96127 |
|
2,448 |
2,264 |
$10K |
| 90461 |
|
419 |
398 |
$10K |
| 92551 |
|
993 |
869 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
668 |
633 |
$8K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
106 |
104 |
$8K |
| 99462 |
|
378 |
273 |
$8K |
| 90832 |
Psychotherapy, 30 minutes with patient |
192 |
157 |
$6K |
| D0330 |
Panoramic radiographic image |
141 |
141 |
$5K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
136 |
131 |
$5K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
50 |
47 |
$4K |
| D0272 |
Bitewings - two radiographic images |
211 |
210 |
$4K |
| 90670 |
|
1,846 |
1,709 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
273 |
237 |
$3K |
| D1110 |
Prophylaxis - adult |
61 |
61 |
$3K |
| D0274 |
Bitewings - four radiographic images |
88 |
88 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
62 |
50 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
164 |
148 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
38 |
26 |
$2K |
| 90686 |
|
5,383 |
5,136 |
$2K |
| 99174 |
|
91 |
88 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
120 |
118 |
$2K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
37 |
12 |
$1K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
19 |
12 |
$1K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
17 |
13 |
$972.40 |
| 96160 |
|
461 |
430 |
$968.61 |
| 99417 |
Prolong home eval add 15m |
31 |
28 |
$926.40 |
| D0220 |
Intraoral - periapical first radiographic image |
104 |
98 |
$890.58 |
| D1351 |
Sealant - per tooth |
37 |
13 |
$547.96 |
| D0140 |
Limited oral evaluation - problem focused |
13 |
13 |
$400.95 |
| 90723 |
|
264 |
235 |
$271.41 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$252.60 |
| 90681 |
|
215 |
196 |
$218.49 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$183.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
28 |
25 |
$172.69 |
| 81025 |
|
31 |
30 |
$159.29 |
| 90651 |
|
80 |
77 |
$102.60 |
| 90647 |
|
386 |
348 |
$92.24 |
| 90734 |
|
83 |
78 |
$88.06 |
| 90648 |
|
226 |
212 |
$52.42 |
| 90633 |
|
506 |
477 |
$29.55 |
| 90685 |
|
39 |
39 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 90710 |
|
13 |
12 |
$0.00 |
| 90620 |
|
12 |
12 |
$0.00 |
| 90696 |
|
13 |
12 |
$0.00 |