| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29,862 |
23,544 |
$1.03M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
1,556 |
1,298 |
$342K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
7,711 |
6,246 |
$303K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,124 |
4,519 |
$222K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,970 |
7,363 |
$199K |
| T1015 |
Clinic visit/encounter, all-inclusive |
213 |
199 |
$136K |
| D1206 |
Topical application of fluoride varnish |
8,498 |
8,353 |
$115K |
| D0140 |
Limited oral evaluation - problem focused |
5,113 |
4,829 |
$107K |
| A0390 |
Als mileage (per mile) |
1,185 |
1,017 |
$106K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,402 |
1,591 |
$94K |
| 80306 |
|
5,283 |
2,201 |
$78K |
| D1110 |
Prophylaxis - adult |
2,362 |
2,307 |
$68K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,225 |
1,957 |
$68K |
| D1120 |
Prophylaxis - child |
2,793 |
2,766 |
$65K |
| D0274 |
Bitewings - four radiographic images |
2,290 |
2,264 |
$47K |
| D0120 |
Periodic oral evaluation - established patient |
2,540 |
2,470 |
$41K |
| 90837 |
Psychotherapy, 53 minutes with patient |
910 |
459 |
$37K |
| D0220 |
Intraoral - periapical first radiographic image |
4,289 |
4,117 |
$36K |
| D1351 |
Sealant - per tooth |
2,101 |
592 |
$29K |
| 92015 |
Determination of refractive state |
3,829 |
3,270 |
$25K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
740 |
649 |
$22K |
| 90832 |
Psychotherapy, 30 minutes with patient |
404 |
332 |
$10K |
| 99000 |
|
3,425 |
2,682 |
$10K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
230 |
191 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
650 |
307 |
$9K |
| 90686 |
|
682 |
662 |
$8K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
458 |
202 |
$8K |
| 90688 |
|
539 |
407 |
$6K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
305 |
129 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
207 |
174 |
$5K |
| D0270 |
|
597 |
560 |
$5K |
| D7140 |
Extraction, erupted tooth or exposed root |
103 |
84 |
$5K |
| A0394 |
Als specialized service disposable supplies; iv drug therapy |
185 |
157 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
270 |
102 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
210 |
167 |
$2K |
| D0272 |
Bitewings - two radiographic images |
132 |
131 |
$2K |
| D0330 |
Panoramic radiographic image |
64 |
64 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
290 |
225 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
27 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
25 |
$1K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
54 |
50 |
$1K |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$952.90 |
| 90480 |
|
53 |
53 |
$900.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
155 |
134 |
$873.47 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
18 |
12 |
$859.74 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$792.74 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
27 |
12 |
$731.99 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$731.76 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
40 |
30 |
$713.24 |
| 81001 |
|
254 |
198 |
$707.31 |
| 90656 |
|
39 |
39 |
$675.03 |
| A0382 |
Bls routine disposable supplies |
109 |
98 |
$583.63 |
| 85027 |
|
79 |
76 |
$381.63 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
43 |
40 |
$312.16 |
| 90756 |
|
18 |
18 |
$258.53 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
30 |
25 |
$181.78 |
| 90715 |
|
12 |
12 |
$165.00 |
| 80061 |
Lipid panel |
14 |
14 |
$147.29 |
| 92310 |
|
138 |
114 |
$75.00 |
| 90734 |
|
12 |
12 |
$36.41 |
| 90651 |
|
12 |
12 |
$36.41 |
| 92250 |
|
14 |
13 |
$24.85 |
| 90863 |
|
435 |
353 |
$0.00 |
| D0191 |
|
4,072 |
4,033 |
$0.00 |
| D1330 |
|
489 |
485 |
$0.00 |
| D1353 |
|
27 |
17 |
$0.00 |
| D0170 |
|
44 |
43 |
$0.00 |