| Code | Description | Claims | Beneficiaries | Total Paid |
| 99199 |
Unlisted special service, procedure or report |
554,377 |
477,833 |
$2.96M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,241 |
4,187 |
$626K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,748 |
4,467 |
$419K |
| 59426 |
|
648 |
617 |
$414K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
9,549 |
7,569 |
$318K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,766 |
1,437 |
$210K |
| D1120 |
Prophylaxis - child |
4,519 |
4,427 |
$141K |
| D0120 |
Periodic oral evaluation - established patient |
3,771 |
3,688 |
$111K |
| D1206 |
Topical application of fluoride varnish |
6,079 |
5,930 |
$110K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,995 |
1,948 |
$95K |
| 99600 |
Unlisted home visit service or procedure |
1,090 |
659 |
$88K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,031 |
401 |
$86K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,421 |
1,887 |
$84K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,296 |
5,087 |
$81K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
1,372 |
1,197 |
$62K |
| 81025 |
|
8,545 |
7,080 |
$62K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,152 |
963 |
$60K |
| 87210 |
|
7,733 |
6,487 |
$58K |
| D1351 |
Sealant - per tooth |
1,830 |
398 |
$55K |
| D0330 |
Panoramic radiographic image |
846 |
810 |
$53K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,331 |
1,935 |
$52K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
359 |
238 |
$39K |
| T1002 |
Rn services, up to 15 minutes |
968 |
759 |
$33K |
| 86592 |
|
6,137 |
5,250 |
$30K |
| 82120 |
|
7,645 |
6,408 |
$28K |
| D0272 |
Bitewings - two radiographic images |
1,334 |
1,309 |
$28K |
| D1110 |
Prophylaxis - adult |
657 |
635 |
$27K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,739 |
1,340 |
$26K |
| 0001A |
|
452 |
355 |
$25K |
| 0002A |
|
557 |
337 |
$25K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
3,569 |
3,180 |
$22K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
4,846 |
4,110 |
$19K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
4,909 |
4,167 |
$18K |
| D0274 |
Bitewings - four radiographic images |
499 |
478 |
$17K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
161 |
141 |
$15K |
| 85018 |
|
5,312 |
4,386 |
$14K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,430 |
1,249 |
$13K |
| 99215 |
Prolong outpt/office vis |
81 |
75 |
$13K |
| 90715 |
|
1,316 |
1,084 |
$10K |
| 90651 |
|
633 |
532 |
$8K |
| 36415 |
Collection of venous blood by venipuncture |
3,183 |
2,616 |
$8K |
| 90734 |
|
1,140 |
943 |
$8K |
| D0220 |
Intraoral - periapical first radiographic image |
471 |
461 |
$8K |
| 96127 |
|
1,767 |
1,468 |
$8K |
| 59025 |
Fetal non-stress test |
212 |
176 |
$6K |
| 0071A |
|
118 |
84 |
$6K |
| 90682 |
|
206 |
123 |
$6K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
54 |
52 |
$5K |
| 0072A |
|
89 |
72 |
$5K |
| 82950 |
|
817 |
768 |
$5K |
| 0004A |
|
100 |
75 |
$5K |
| 59425 |
|
13 |
13 |
$5K |
| 87081 |
|
687 |
455 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
19 |
15 |
$3K |
| 87400 |
|
228 |
201 |
$3K |
| 80061 |
Lipid panel |
196 |
176 |
$3K |
| 81002 |
|
1,158 |
767 |
$3K |
| 83986 |
|
486 |
413 |
$2K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
14 |
12 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
25 |
24 |
$2K |
| 90619 |
|
797 |
619 |
$2K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
13 |
12 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
17 |
$2K |
| 90686 |
|
675 |
518 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
84 |
79 |
$1K |
| 99441 |
|
319 |
81 |
$1K |
| 90716 |
|
49 |
44 |
$1K |
| 86703 |
|
3,701 |
3,140 |
$1K |
| 99406 |
|
87 |
84 |
$978.26 |
| 90673 |
|
15 |
13 |
$822.69 |
| 90688 |
|
184 |
169 |
$787.68 |
| 99402 |
|
2,141 |
1,447 |
$696.41 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
73 |
64 |
$595.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
80 |
70 |
$505.94 |
| 92551 |
|
557 |
476 |
$479.24 |
| 90620 |
|
41 |
36 |
$433.78 |
| 82951 |
|
28 |
24 |
$392.88 |
| 90480 |
|
13 |
13 |
$356.51 |
| 90707 |
|
14 |
14 |
$138.46 |
| 90633 |
|
206 |
188 |
$129.20 |
| 96160 |
|
31 |
27 |
$112.20 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
521 |
422 |
$102.22 |
| 86787 |
|
1,115 |
983 |
$72.24 |
| 90656 |
|
17 |
17 |
$61.59 |
| 86803 |
|
26 |
25 |
$53.36 |
| 99173 |
|
592 |
510 |
$42.54 |
| 82947 |
|
15 |
13 |
$39.92 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,153 |
1,021 |
$37.16 |
| 99401 |
|
3,563 |
3,075 |
$29.94 |
| 91300 |
|
1,229 |
788 |
$20.01 |
| 82105 |
|
37 |
35 |
$9.00 |
| 86900 |
|
1,073 |
948 |
$0.00 |
| 83020 |
|
520 |
453 |
$0.00 |
| 90713 |
|
12 |
12 |
$0.00 |
| 90700 |
|
26 |
25 |
$0.00 |
| 90710 |
|
46 |
41 |
$0.00 |
| 87149 |
|
93 |
89 |
$0.00 |
| 86901 |
|
1,086 |
955 |
$0.00 |
| 99000 |
|
515 |
358 |
$0.00 |
| 86850 |
|
1,106 |
977 |
$0.00 |
| 86762 |
|
1,081 |
957 |
$0.00 |
| 87340 |
|
1,080 |
955 |
$0.00 |
| 91301 |
|
28 |
27 |
$0.00 |
| 91307 |
|
225 |
148 |
$0.00 |