| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
173,463 |
86,460 |
$10.27M |
| 36415 |
Collection of venous blood by venipuncture |
105,011 |
34,736 |
$1.99M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
32,383 |
17,509 |
$1.95M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17,638 |
6,616 |
$602K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
15,474 |
3,069 |
$578K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15,183 |
5,714 |
$550K |
| D0120 |
Periodic oral evaluation - established patient |
17,675 |
8,108 |
$471K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
11,071 |
4,798 |
$460K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
9,530 |
3,408 |
$424K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
6,358 |
3,007 |
$389K |
| 90832 |
Psychotherapy, 30 minutes with patient |
5,381 |
2,900 |
$389K |
| 99215 |
Prolong outpt/office vis |
4,287 |
2,450 |
$358K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,241 |
2,807 |
$353K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
9,900 |
2,209 |
$280K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,898 |
1,663 |
$256K |
| D1110 |
Prophylaxis - adult |
7,364 |
4,778 |
$220K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,788 |
2,655 |
$200K |
| 97124 |
|
4,159 |
1,245 |
$186K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,634 |
1,857 |
$176K |
| 99441 |
|
2,335 |
1,728 |
$167K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13,504 |
13,415 |
$157K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,792 |
1,423 |
$133K |
| D0220 |
Intraoral - periapical first radiographic image |
5,955 |
3,325 |
$131K |
| 99442 |
|
2,011 |
1,109 |
$101K |
| 97014 |
|
3,940 |
1,724 |
$96K |
| 97161 |
|
1,808 |
522 |
$72K |
| D1120 |
Prophylaxis - child |
2,417 |
1,441 |
$71K |
| 96127 |
|
11,869 |
10,375 |
$64K |
| 99443 |
|
786 |
343 |
$52K |
| 90461 |
|
4,877 |
4,870 |
$51K |
| D0274 |
Bitewings - four radiographic images |
2,623 |
2,570 |
$46K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,173 |
317 |
$38K |
| D0140 |
Limited oral evaluation - problem focused |
1,721 |
1,455 |
$35K |
| D1330 |
|
2,960 |
2,120 |
$26K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
479 |
235 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,336 |
2,253 |
$20K |
| 92551 |
|
8,548 |
8,539 |
$20K |
| 81025 |
|
3,558 |
3,487 |
$19K |
| 99173 |
|
6,368 |
6,359 |
$18K |
| D0210 |
Intraoral - complete series of radiographic images |
572 |
561 |
$16K |
| 90863 |
|
310 |
205 |
$14K |
| 99000 |
|
24,441 |
23,694 |
$12K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
501 |
446 |
$11K |
| D2140 |
|
164 |
96 |
$10K |
| 90686 |
|
2,573 |
2,572 |
$10K |
| Q3014 |
Telehealth originating site facility fee |
271 |
183 |
$9K |
| 98968 |
|
115 |
42 |
$7K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
109 |
63 |
$7K |
| D1351 |
Sealant - per tooth |
160 |
53 |
$6K |
| 92015 |
Determination of refractive state |
1,574 |
1,516 |
$6K |
| 92002 |
|
130 |
48 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
75 |
43 |
$5K |
| 82948 |
|
3,391 |
3,116 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
44 |
26 |
$4K |
| 99051 |
|
33 |
32 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
406 |
382 |
$3K |
| 92202 |
|
201 |
186 |
$2K |
| 81002 |
|
1,441 |
1,212 |
$2K |
| 99383 |
|
107 |
25 |
$2K |
| 97802 |
|
38 |
38 |
$2K |
| D0272 |
Bitewings - two radiographic images |
144 |
136 |
$2K |
| 99384 |
|
171 |
12 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
21 |
12 |
$2K |
| 3074F |
|
12,928 |
11,980 |
$2K |
| 3078F |
|
11,450 |
10,681 |
$1K |
| 11721 |
|
96 |
96 |
$1K |
| 92225 |
|
65 |
63 |
$1K |
| D0270 |
|
39 |
13 |
$1K |
| 97803 |
|
25 |
25 |
$936.74 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
132 |
131 |
$920.45 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
83 |
82 |
$903.24 |
| 90656 |
|
327 |
327 |
$793.42 |
| 3079F |
|
3,923 |
3,722 |
$770.00 |
| D9110 |
|
19 |
12 |
$702.19 |
| 90688 |
|
141 |
141 |
$650.83 |
| 90651 |
|
267 |
267 |
$623.37 |
| 90715 |
|
65 |
64 |
$382.68 |
| 1126F |
|
17,967 |
16,165 |
$374.02 |
| 97010 |
|
1,211 |
611 |
$236.05 |
| 93000 |
|
36 |
36 |
$210.00 |
| 85018 |
|
113 |
113 |
$207.29 |
| 1160F |
|
19,087 |
16,841 |
$205.00 |
| 3075F |
|
1,381 |
1,333 |
$135.00 |
| 1159F |
|
16,370 |
14,452 |
$120.00 |
| D0601 |
|
2,853 |
2,844 |
$105.71 |
| 94150 |
|
145 |
139 |
$101.19 |
| 3077F |
|
973 |
924 |
$82.50 |
| 90655 |
|
176 |
176 |
$16.11 |
| 3008F |
|
20,314 |
18,300 |
$0.00 |
| 1036F |
|
15,232 |
13,190 |
$0.00 |
| 1125F |
|
1,370 |
1,312 |
$0.00 |
| 1034F |
|
912 |
784 |
$0.00 |
| D0603 |
|
192 |
192 |
$0.00 |
| 3080F |
|
294 |
281 |
$0.00 |
| 90620 |
|
36 |
36 |
$0.00 |
| 90698 |
|
99 |
99 |
$0.00 |
| 1220F |
|
56 |
56 |
$0.00 |
| 90696 |
|
15 |
15 |
$0.00 |
| 90619 |
|
12 |
12 |
$0.00 |
| 4010F |
|
15 |
15 |
$0.00 |
| 90647 |
|
13 |
13 |
$0.00 |
| 3061F |
|
12 |
12 |
$0.00 |
| 3725F |
|
13,621 |
11,890 |
$0.00 |
| 90670 |
|
516 |
515 |
$0.00 |
| D0190 |
|
19 |
19 |
$0.00 |
| 90633 |
|
134 |
133 |
$0.00 |
| 90710 |
|
168 |
168 |
$0.00 |
| 90653 |
|
88 |
88 |
$0.00 |
| 90734 |
|
190 |
190 |
$0.00 |
| 2022F |
|
37 |
37 |
$0.00 |
| 90671 |
|
13 |
13 |
$0.00 |
| S9083 |
Global fee urgent care centers |
18 |
18 |
$0.00 |