| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
480 |
477 |
$0.00 |
| 99442 |
|
1,188 |
1,143 |
$0.00 |
| G9920 |
Screening performed and negative |
311 |
311 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
399 |
399 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
492 |
476 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
70 |
70 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| D1120 |
Prophylaxis - child |
511 |
511 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
661 |
658 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
468 |
456 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
970 |
935 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
546 |
543 |
$0.00 |
| 3078F |
|
1,569 |
1,460 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
341 |
337 |
$0.00 |
| 80061 |
Lipid panel |
894 |
893 |
$0.00 |
| D0350 |
|
280 |
280 |
$0.00 |
| 90734 |
|
107 |
107 |
$0.00 |
| 82248 |
|
27 |
27 |
$0.00 |
| 85014 |
|
26 |
26 |
$0.00 |
| 80076 |
|
72 |
72 |
$0.00 |
| 96160 |
|
55 |
55 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$0.00 |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
18 |
18 |
$0.00 |
| 90715 |
|
15 |
15 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
449 |
449 |
$0.00 |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
212 |
210 |
$0.00 |
| D1330 |
|
526 |
522 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
554 |
553 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
367 |
366 |
$0.00 |
| 3074F |
|
1,635 |
1,512 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,905 |
1,826 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
333 |
332 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
974 |
966 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
860 |
859 |
$0.00 |
| 70300 |
|
568 |
564 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
423 |
421 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
2,107 |
2,044 |
$0.00 |
| 3044F |
|
222 |
222 |
$0.00 |
| 85027 |
|
350 |
348 |
$0.00 |
| 99441 |
|
528 |
502 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
312 |
312 |
$0.00 |
| 90651 |
|
158 |
158 |
$0.00 |
| 96161 |
|
105 |
105 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
25 |
25 |
$0.00 |
| 99443 |
|
41 |
38 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
88 |
88 |
$0.00 |
| 3079F |
|
54 |
54 |
$0.00 |
| 85018 |
|
26 |
26 |
$0.00 |
| 82728 |
|
26 |
26 |
$0.00 |
| 90686 |
|
204 |
204 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
83 |
74 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
40 |
40 |
$0.00 |
| 1111F |
|
474 |
436 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
56 |
56 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
111 |
111 |
$0.00 |
| 90656 |
|
73 |
73 |
$0.00 |
| 91307 |
|
14 |
14 |
$0.00 |
| 4450F |
|
12 |
12 |
$0.00 |