| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28,969 |
24,790 |
$3.02M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,699 |
8,215 |
$1.05M |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
10,873 |
5,107 |
$632K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,615 |
3,447 |
$397K |
| 36415 |
Collection of venous blood by venipuncture |
13,938 |
3,107 |
$344K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
4,001 |
2,455 |
$301K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,602 |
1,160 |
$222K |
| D0120 |
Periodic oral evaluation - established patient |
5,623 |
1,399 |
$171K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
3,241 |
1,301 |
$170K |
| D1110 |
Prophylaxis - adult |
1,264 |
1,119 |
$135K |
| 99215 |
Prolong outpt/office vis |
852 |
772 |
$112K |
| 94760 |
|
1,272 |
627 |
$102K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,397 |
726 |
$82K |
| 95117 |
|
1,432 |
461 |
$81K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
595 |
585 |
$67K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
595 |
510 |
$60K |
| 99205 |
Prolong outpt/office vis |
458 |
396 |
$50K |
| D0220 |
Intraoral - periapical first radiographic image |
1,422 |
654 |
$49K |
| D0140 |
Limited oral evaluation - problem focused |
1,076 |
374 |
$48K |
| 90656 |
|
1,298 |
409 |
$38K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
242 |
230 |
$35K |
| D9430 |
|
165 |
155 |
$21K |
| 92551 |
|
529 |
135 |
$18K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
580 |
142 |
$17K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
147 |
127 |
$14K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
110 |
95 |
$12K |
| 97802 |
|
64 |
61 |
$11K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
73 |
73 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
465 |
92 |
$9K |
| 97803 |
|
55 |
54 |
$8K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
97 |
42 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
31 |
30 |
$4K |
| D5110 |
|
31 |
26 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
18 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
19 |
19 |
$2K |
| 36410 |
|
38 |
15 |
$2K |
| 92015 |
Determination of refractive state |
1,120 |
1,097 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
25 |
13 |
$2K |
| D3310 |
|
17 |
15 |
$1K |
| 11720 |
|
32 |
12 |
$1K |
| D9991 |
|
14 |
13 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
47 |
43 |
$410.00 |
| D0274 |
Bitewings - four radiographic images |
13 |
13 |
$288.00 |
| 99441 |
|
22 |
22 |
$168.92 |