| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
50,382 |
41,903 |
$343K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,755 |
12,576 |
$264K |
| D1110 |
Prophylaxis - adult |
3,626 |
3,443 |
$96K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,364 |
1,988 |
$94K |
| 99051 |
|
2,225 |
1,640 |
$42K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,994 |
1,881 |
$42K |
| D0272 |
Bitewings - two radiographic images |
2,470 |
2,335 |
$34K |
| D0120 |
Periodic oral evaluation - established patient |
2,337 |
2,210 |
$32K |
| D1999 |
|
2,044 |
1,881 |
$28K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,936 |
1,807 |
$27K |
| 97803 |
|
2,306 |
2,027 |
$26K |
| 97802 |
|
1,829 |
1,567 |
$26K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,046 |
1,185 |
$24K |
| 93000 |
|
3,745 |
3,437 |
$23K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22,417 |
19,619 |
$21K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
410 |
288 |
$19K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
230 |
213 |
$17K |
| 99215 |
Prolong outpt/office vis |
1,971 |
1,378 |
$16K |
| D1208 |
Topical application of fluoride, excluding varnish |
922 |
858 |
$12K |
| D0330 |
Panoramic radiographic image |
340 |
326 |
$10K |
| D1120 |
Prophylaxis - child |
585 |
529 |
$10K |
| D7140 |
Extraction, erupted tooth or exposed root |
125 |
94 |
$8K |
| D0140 |
Limited oral evaluation - problem focused |
429 |
412 |
$7K |
| 76536 |
|
336 |
307 |
$7K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
191 |
174 |
$7K |
| 76830 |
Ultrasound, transvaginal |
231 |
212 |
$6K |
| 99443 |
|
322 |
301 |
$6K |
| 99441 |
|
2,571 |
2,366 |
$6K |
| D0230 |
Intraoral - periapical each additional radiographic image |
700 |
481 |
$6K |
| D2160 |
|
74 |
60 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
504 |
474 |
$4K |
| D2140 |
|
87 |
61 |
$2K |
| 99205 |
Prolong outpt/office vis |
20 |
14 |
$2K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
2,795 |
2,346 |
$2K |
| 90651 |
|
615 |
383 |
$2K |
| 99442 |
|
2,312 |
1,925 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
581 |
543 |
$2K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
88 |
82 |
$2K |
| 96160 |
|
1,008 |
620 |
$2K |
| 90734 |
|
507 |
301 |
$1K |
| 90716 |
|
432 |
268 |
$1K |
| 99242 |
|
46 |
44 |
$960.00 |
| 76770 |
|
42 |
41 |
$863.52 |
| 94664 |
|
178 |
160 |
$683.47 |
| 96127 |
|
10,946 |
8,088 |
$579.24 |
| 90707 |
|
397 |
244 |
$564.80 |
| 99243 |
|
106 |
106 |
$563.00 |
| 94760 |
|
158 |
154 |
$486.10 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
178 |
176 |
$437.19 |
| 90621 |
|
94 |
60 |
$408.86 |
| 90696 |
|
195 |
116 |
$297.10 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,228 |
1,000 |
$242.91 |
| 90670 |
|
687 |
408 |
$217.30 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
756 |
656 |
$211.68 |
| 99050 |
|
3,107 |
2,818 |
$198.00 |
| 90620 |
|
192 |
104 |
$164.75 |
| 90633 |
|
389 |
229 |
$160.28 |
| 90715 |
|
239 |
147 |
$132.07 |
| 90688 |
|
98 |
88 |
$112.62 |
| 72100 |
|
204 |
181 |
$108.59 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
14 |
14 |
$98.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
518 |
358 |
$81.67 |
| 90686 |
|
396 |
270 |
$68.06 |
| 90656 |
|
97 |
88 |
$67.20 |
| 90685 |
|
122 |
79 |
$46.07 |
| 20610 |
|
14 |
14 |
$46.00 |
| 72040 |
|
98 |
92 |
$36.37 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
520 |
455 |
$30.00 |
| 99384 |
|
113 |
112 |
$30.00 |
| 73560 |
|
30 |
27 |
$22.30 |
| 90700 |
|
191 |
117 |
$16.00 |
| 90648 |
|
393 |
234 |
$12.00 |
| 90681 |
|
298 |
182 |
$4.00 |
| 90698 |
|
260 |
159 |
$4.00 |
| D1330 |
|
2,107 |
2,022 |
$0.14 |
| D1310 |
|
2,110 |
2,023 |
$0.14 |
| D0603 |
|
1,291 |
1,242 |
$0.08 |
| D0602 |
|
749 |
716 |
$0.03 |
| 1160F |
|
40,899 |
32,064 |
$0.01 |
| 1159F |
|
41,883 |
32,996 |
$0.01 |
| 3078F |
|
28,965 |
22,341 |
$0.01 |
| 1126F |
|
25,901 |
19,296 |
$0.01 |
| 3075F |
|
5,305 |
4,204 |
$0.01 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
249 |
227 |
$0.00 |
| 3725F |
|
12,694 |
9,618 |
$0.00 |
| 2028F |
|
971 |
767 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
78 |
51 |
$0.00 |
| 99408 |
|
371 |
242 |
$0.00 |
| 3077F |
|
2,411 |
1,958 |
$0.00 |
| G8598 |
Aspirin or another antiplatelet therapy used |
266 |
252 |
$0.00 |
| 4004F |
|
195 |
189 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
701 |
503 |
$0.00 |
| 3050F |
|
98 |
80 |
$0.00 |
| 99348 |
|
34 |
26 |
$0.00 |
| 99401 |
|
67 |
52 |
$0.00 |
| 3062F |
|
40 |
40 |
$0.00 |
| 90655 |
|
25 |
23 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
33 |
32 |
$0.00 |
| 3074F |
|
24,935 |
19,256 |
$0.00 |
| 1036F |
|
5,366 |
4,378 |
$0.00 |
| 3044F |
|
2,127 |
1,637 |
$0.00 |
| 3079F |
|
4,513 |
3,720 |
$0.00 |
| 1125F |
|
8,977 |
7,160 |
$0.00 |
| 2000F |
|
4,395 |
3,674 |
$0.00 |
| 3008F |
|
10,415 |
9,006 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
9,318 |
6,835 |
$0.00 |
| 3049F |
|
308 |
263 |
$0.00 |
| 1101F |
|
532 |
496 |
$0.00 |
| 3080F |
|
320 |
257 |
$0.00 |
| 1034F |
|
199 |
157 |
$0.00 |
| 1170F |
|
1,376 |
1,034 |
$0.00 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
185 |
117 |
$0.00 |
| 1000F |
|
5,177 |
4,152 |
$0.00 |
| 3048F |
|
1,243 |
1,015 |
$0.00 |
| 4010F |
|
804 |
742 |
$0.00 |
| 3061F |
|
508 |
438 |
$0.00 |
| 4000F |
|
361 |
325 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
288 |
165 |
$0.00 |
| 90723 |
|
84 |
43 |
$0.00 |
| 76641 |
|
13 |
12 |
$0.00 |
| 99383 |
|
123 |
113 |
$0.00 |
| 99368 |
|
16 |
13 |
$0.00 |
| 3014F |
|
173 |
109 |
$0.00 |
| 90744 |
|
110 |
73 |
$0.00 |
| 1030F |
|
68 |
68 |
$0.00 |
| 3017F |
|
27 |
25 |
$0.00 |
| 1022F |
|
31 |
31 |
$0.00 |
| 37252 |
|
17 |
17 |
$0.00 |