| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
73,248 |
68,590 |
$1.40M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16,299 |
16,082 |
$859K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13,730 |
13,560 |
$711K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
10,251 |
10,020 |
$525K |
| D0145 |
Oral evaluation for a patient under three years of age |
3,350 |
3,296 |
$441K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
6,738 |
6,648 |
$378K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
77,571 |
32,926 |
$321K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,629 |
12,113 |
$228K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
4,649 |
4,542 |
$194K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
3,557 |
3,361 |
$186K |
| D1120 |
Prophylaxis - child |
5,244 |
5,091 |
$168K |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,295 |
3,582 |
$164K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,471 |
3,363 |
$146K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,502 |
7,918 |
$143K |
| 90791 |
Psychiatric diagnostic evaluation |
2,847 |
2,836 |
$142K |
| D0120 |
Periodic oral evaluation - established patient |
5,199 |
5,041 |
$134K |
| 90461 |
|
19,780 |
16,025 |
$117K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
740 |
725 |
$98K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
1,313 |
719 |
$87K |
| D0272 |
Bitewings - two radiographic images |
3,826 |
3,709 |
$78K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,069 |
1,007 |
$75K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
18,374 |
12,477 |
$73K |
| D1206 |
Topical application of fluoride varnish |
5,458 |
5,305 |
$71K |
| V2020 |
Frames, purchases |
4,841 |
4,706 |
$67K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
5,976 |
2,285 |
$64K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
513 |
150 |
$57K |
| D0220 |
Intraoral - periapical first radiographic image |
5,200 |
5,006 |
$56K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
10,457 |
10,231 |
$52K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,956 |
2,762 |
$51K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
570 |
345 |
$50K |
| D0230 |
Intraoral - periapical each additional radiographic image |
5,067 |
4,779 |
$50K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,008 |
2,954 |
$47K |
| 59430 |
|
550 |
547 |
$45K |
| D1351 |
Sealant - per tooth |
1,393 |
327 |
$33K |
| 99215 |
Prolong outpt/office vis |
1,124 |
1,070 |
$32K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
527 |
525 |
$32K |
| D1110 |
Prophylaxis - adult |
625 |
604 |
$31K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
352 |
226 |
$26K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
317 |
291 |
$23K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,156 |
3,088 |
$23K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
2,108 |
1,405 |
$20K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,976 |
2,946 |
$18K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
39 |
39 |
$17K |
| 92523 |
|
269 |
268 |
$17K |
| D0274 |
Bitewings - four radiographic images |
604 |
577 |
$16K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
634 |
596 |
$15K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
447 |
433 |
$14K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
464 |
458 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,426 |
1,371 |
$14K |
| 59025 |
Fetal non-stress test |
816 |
573 |
$11K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,252 |
3,162 |
$11K |
| 84703 |
|
3,288 |
3,218 |
$10K |
| 76801 |
|
252 |
241 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
308 |
282 |
$9K |
| D1208 |
Topical application of fluoride, excluding varnish |
682 |
656 |
$9K |
| 90837 |
Psychotherapy, 53 minutes with patient |
347 |
325 |
$9K |
| 99381 |
|
100 |
99 |
$8K |
| 80061 |
Lipid panel |
3,613 |
3,450 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,493 |
3,474 |
$8K |
| D0210 |
Intraoral - complete series of radiographic images |
135 |
131 |
$7K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
717 |
510 |
$6K |
| D0330 |
Panoramic radiographic image |
176 |
163 |
$6K |
| 99205 |
Prolong outpt/office vis |
133 |
133 |
$5K |
| 76820 |
|
202 |
109 |
$5K |
| 90620 |
|
102 |
102 |
$5K |
| 76830 |
Ultrasound, transvaginal |
84 |
83 |
$5K |
| 82947 |
|
5,922 |
5,515 |
$4K |
| 81002 |
|
1,445 |
1,342 |
$3K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
35 |
12 |
$2K |
| D0170 |
|
176 |
170 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
223 |
164 |
$2K |
| 90715 |
|
461 |
456 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,969 |
1,960 |
$2K |
| 84460 |
|
2,807 |
2,678 |
$2K |
| 84450 |
|
2,807 |
2,678 |
$2K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
93 |
69 |
$2K |
| V2025 |
Deluxe frame |
100 |
94 |
$2K |
| 76821 |
|
27 |
14 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
14 |
14 |
$1K |
| 90734 |
|
345 |
332 |
$830.10 |
| 96158 |
|
156 |
127 |
$806.12 |
| 90474 |
|
83 |
83 |
$781.03 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
14 |
14 |
$624.98 |
| 90686 |
|
17,502 |
17,240 |
$594.42 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
42 |
25 |
$435.96 |
| 90651 |
|
2,227 |
2,192 |
$308.46 |
| 99241 |
|
13 |
13 |
$247.00 |
| D0140 |
Limited oral evaluation - problem focused |
12 |
12 |
$225.36 |
| 81025 |
|
30 |
28 |
$214.08 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
14 |
$188.39 |
| 92587 |
|
65 |
63 |
$92.62 |
| 90688 |
|
1,594 |
1,589 |
$21.75 |
| 0001A |
|
2,057 |
1,815 |
$18.76 |
| 85018 |
|
74 |
43 |
$17.08 |
| 87999 |
|
353 |
351 |
$3.17 |
| 90619 |
|
374 |
370 |
$0.04 |
| 90670 |
|
8,482 |
8,356 |
$0.01 |
| 90723 |
|
1,518 |
1,492 |
$0.00 |
| 96127 |
|
14,822 |
12,642 |
$0.00 |
| 96040 |
|
134 |
132 |
$0.00 |
| 90696 |
|
337 |
333 |
$0.00 |
| D0603 |
|
8,391 |
7,887 |
$0.00 |
| 96161 |
|
2,001 |
1,997 |
$0.00 |
| 90680 |
|
4,749 |
4,714 |
$0.00 |
| 82962 |
|
585 |
555 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
2,790 |
2,203 |
$0.00 |
| 90698 |
|
171 |
170 |
$0.00 |
| 97802 |
|
659 |
655 |
$0.00 |
| 90697 |
|
1,255 |
1,251 |
$0.00 |
| 90677 |
|
1,089 |
1,088 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
365 |
363 |
$0.00 |
| D0602 |
|
1,392 |
1,319 |
$0.00 |
| 90480 |
|
168 |
168 |
$0.00 |
| 90716 |
|
203 |
197 |
$0.00 |
| 0081A |
|
59 |
59 |
$0.00 |
| 36416 |
|
170 |
119 |
$0.00 |
| 91315 |
|
15 |
15 |
$0.00 |
| 0082A |
|
32 |
32 |
$0.00 |
| 0074A |
|
47 |
47 |
$0.00 |
| 91307 |
|
63 |
61 |
$0.00 |
| 90656 |
|
50 |
46 |
$0.00 |
| 0072A |
|
14 |
14 |
$0.00 |
| 90685 |
|
1,073 |
1,068 |
$0.00 |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
13 |
13 |
$0.00 |
| 90707 |
|
198 |
192 |
$0.00 |
| 90633 |
|
3,216 |
3,144 |
$0.00 |
| 90648 |
|
4,133 |
4,070 |
$0.00 |
| 90710 |
|
353 |
348 |
$0.00 |
| 90700 |
|
143 |
135 |
$0.00 |
| 97803 |
|
904 |
817 |
$0.00 |
| 87420 |
|
29 |
29 |
$0.00 |
| 91300 |
|
112 |
112 |
$0.00 |
| 0054A |
|
38 |
38 |
$0.00 |
| 0071A |
|
30 |
30 |
$0.00 |
| 91308 |
|
108 |
103 |
$0.00 |
| 90687 |
|
73 |
70 |
$0.00 |
| 91312 |
|
30 |
30 |
$0.00 |