| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
75,332 |
69,296 |
$2.34M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17,522 |
17,262 |
$858K |
| H1000 |
Prenatal care, at-risk assessment |
13,274 |
9,131 |
$791K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13,133 |
12,792 |
$662K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
10,442 |
10,346 |
$507K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,289 |
10,544 |
$423K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
6,129 |
6,048 |
$278K |
| D0120 |
Periodic oral evaluation - established patient |
10,570 |
9,856 |
$222K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,905 |
8,482 |
$213K |
| D1110 |
Prophylaxis - adult |
4,897 |
4,552 |
$208K |
| D1120 |
Prophylaxis - child |
6,548 |
6,107 |
$200K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,604 |
1,660 |
$177K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
1,367 |
655 |
$166K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,566 |
2,383 |
$113K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
1,850 |
1,287 |
$100K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
3,189 |
1,852 |
$87K |
| D0274 |
Bitewings - four radiographic images |
5,206 |
4,856 |
$72K |
| D1354 |
|
9,852 |
2,650 |
$62K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
28,121 |
26,631 |
$61K |
| H2010 |
Comprehensive medication services, per 15 minutes |
2,397 |
2,154 |
$58K |
| 59410 |
|
59 |
59 |
$58K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
42,480 |
41,764 |
$57K |
| D0140 |
Limited oral evaluation - problem focused |
3,422 |
3,220 |
$57K |
| D1351 |
Sealant - per tooth |
5,084 |
1,696 |
$56K |
| 92587 |
|
15,639 |
15,329 |
$49K |
| D0145 |
Oral evaluation for a patient under three years of age |
1,260 |
1,154 |
$42K |
| D0330 |
Panoramic radiographic image |
789 |
771 |
$39K |
| D0230 |
Intraoral - periapical each additional radiographic image |
14,156 |
11,829 |
$38K |
| D1206 |
Topical application of fluoride varnish |
15,572 |
14,557 |
$29K |
| H0031 |
Mental health assessment, by non-physician |
581 |
491 |
$24K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14,833 |
7,519 |
$23K |
| H2000 |
Comprehensive multidisciplinary evaluation |
113 |
107 |
$19K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,992 |
1,533 |
$17K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
393 |
368 |
$17K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
276 |
247 |
$16K |
| 90832 |
Psychotherapy, 30 minutes with patient |
435 |
332 |
$15K |
| 59430 |
|
280 |
249 |
$13K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,881 |
6,657 |
$10K |
| D7140 |
Extraction, erupted tooth or exposed root |
562 |
213 |
$9K |
| 90834 |
Psychotherapy, 45 minutes with patient |
193 |
130 |
$9K |
| 90686 |
|
18,733 |
18,428 |
$8K |
| H0046 |
Mental health services, not otherwise specified |
648 |
588 |
$8K |
| D1330 |
|
13,290 |
12,388 |
$7K |
| 85018 |
|
9,550 |
9,327 |
$6K |
| D0272 |
Bitewings - two radiographic images |
4,693 |
4,336 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
15,288 |
14,108 |
$5K |
| 0071A |
|
213 |
183 |
$5K |
| 0072A |
|
139 |
117 |
$4K |
| 76801 |
|
74 |
65 |
$4K |
| 81003 |
|
4,506 |
3,277 |
$4K |
| 90473 |
|
2,427 |
2,357 |
$4K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
74 |
67 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
50 |
36 |
$3K |
| 59025 |
Fetal non-stress test |
51 |
30 |
$3K |
| 99385 |
|
36 |
35 |
$2K |
| D0191 |
|
320 |
315 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
29 |
29 |
$2K |
| 90670 |
|
8,308 |
8,059 |
$2K |
| 90723 |
|
6,024 |
5,852 |
$2K |
| 87807 |
|
813 |
774 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
45 |
35 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,800 |
2,733 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
13 |
$2K |
| D0190 |
|
120 |
110 |
$1K |
| D0603 |
|
9,830 |
9,588 |
$1K |
| 83655 |
|
438 |
421 |
$1K |
| 81025 |
|
666 |
566 |
$1K |
| 90651 |
|
1,405 |
1,376 |
$1K |
| 0002A |
|
27 |
27 |
$1K |
| 90648 |
|
9,630 |
9,385 |
$851.09 |
| 99442 |
|
42 |
42 |
$816.96 |
| 90633 |
|
3,118 |
3,026 |
$782.06 |
| 90671 |
|
771 |
767 |
$484.64 |
| 99441 |
|
49 |
49 |
$427.34 |
| 99381 |
|
16 |
15 |
$400.46 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
145 |
131 |
$365.13 |
| 36415 |
Collection of venous blood by venipuncture |
373 |
326 |
$293.60 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
111 |
109 |
$289.70 |
| 94010 |
|
17 |
17 |
$169.44 |
| 90734 |
|
605 |
593 |
$152.01 |
| 90620 |
|
139 |
134 |
$110.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
373 |
363 |
$80.00 |
| 90685 |
|
120 |
120 |
$75.00 |
| 90681 |
|
1,894 |
1,825 |
$65.02 |
| D0270 |
|
342 |
332 |
$56.58 |
| D0601 |
|
78 |
78 |
$50.00 |
| D9110 |
|
49 |
46 |
$49.88 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
31 |
28 |
$38.50 |
| 90696 |
|
39 |
38 |
$35.00 |
| 1036F |
|
10,658 |
8,234 |
$32.56 |
| 90710 |
|
38 |
37 |
$20.00 |
| D0602 |
|
90 |
90 |
$15.00 |
| 90715 |
|
30 |
30 |
$15.00 |
| 90672 |
|
188 |
186 |
$5.00 |
| 82962 |
|
154 |
138 |
$4.32 |
| 90656 |
|
1,420 |
1,415 |
$0.02 |
| 3074F |
|
10,537 |
9,024 |
$0.00 |
| 90716 |
|
29 |
25 |
$0.00 |
| 3008F |
|
17,600 |
14,462 |
$0.00 |
| 99174 |
|
393 |
367 |
$0.00 |
| 90677 |
|
712 |
698 |
$0.00 |
| 91307 |
|
366 |
294 |
$0.00 |
| 99000 |
|
796 |
655 |
$0.00 |
| 3079F |
|
456 |
334 |
$0.00 |
| 90698 |
|
25 |
25 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
320 |
294 |
$0.00 |
| 90674 |
|
280 |
278 |
$0.00 |
| 1126F |
|
872 |
691 |
$0.00 |
| 3075F |
|
43 |
40 |
$0.00 |
| 1125F |
|
33 |
30 |
$0.00 |
| 90381 |
|
29 |
28 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$0.00 |
| D8999 |
|
56 |
40 |
$0.00 |
| 92558 |
|
69 |
69 |
$0.00 |
| 36416 |
|
56 |
48 |
$0.00 |
| 91305 |
|
17 |
13 |
$0.00 |
| 3078F |
|
10,092 |
8,374 |
$0.00 |
| 1160F |
|
4,317 |
3,069 |
$0.00 |
| D9986 |
|
917 |
837 |
$0.00 |
| 3725F |
|
2,032 |
1,382 |
$0.00 |
| 91300 |
|
98 |
90 |
$0.00 |
| 90700 |
|
46 |
40 |
$0.00 |
| 99173 |
|
25 |
14 |
$0.00 |
| 90707 |
|
42 |
38 |
$0.00 |
| 3077F |
|
16 |
14 |
$0.00 |