| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
18,678 |
17,640 |
$1.74M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
10,972 |
10,742 |
$1.19M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24,170 |
23,523 |
$1.00M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,194 |
7,806 |
$500K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,225 |
6,063 |
$447K |
| 99460 |
|
4,115 |
3,949 |
$412K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
22,058 |
20,843 |
$386K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,105 |
4,001 |
$324K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
6,037 |
5,816 |
$297K |
| 92551 |
|
15,392 |
15,066 |
$210K |
| 99479 |
Subsequent intensive care, per day, very low birth weight infant |
1,351 |
476 |
$145K |
| 99469 |
Subsequent inpatient neonatal critical care, per day, 28 days or younger |
417 |
116 |
$122K |
| 99462 |
|
3,633 |
3,107 |
$105K |
| 96112 |
|
1,296 |
1,261 |
$84K |
| 99177 |
|
7,042 |
6,926 |
$79K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
875 |
852 |
$76K |
| 99245 |
|
434 |
427 |
$73K |
| 99215 |
Prolong outpt/office vis |
754 |
740 |
$70K |
| 90461 |
|
5,033 |
4,892 |
$58K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,207 |
2,149 |
$57K |
| 90686 |
|
11,312 |
11,251 |
$47K |
| 99480 |
Subsequent intensive care, per day, low birth weight infant |
473 |
203 |
$45K |
| 99173 |
|
13,527 |
13,239 |
$43K |
| 99222 |
Initial hospital care, per day, moderate complexity |
389 |
382 |
$38K |
| 90670 |
|
7,603 |
7,586 |
$37K |
| 99188 |
|
1,779 |
1,747 |
$35K |
| 36415 |
Collection of venous blood by venipuncture |
9,751 |
9,460 |
$30K |
| 99223 |
Prolong inpt eval add15 m |
210 |
207 |
$29K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,206 |
3,656 |
$28K |
| 90680 |
|
5,699 |
5,683 |
$25K |
| 96127 |
|
5,013 |
4,902 |
$22K |
| 90698 |
|
4,505 |
4,493 |
$22K |
| 99464 |
|
414 |
401 |
$21K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
311 |
242 |
$18K |
| 99499 |
|
452 |
449 |
$17K |
| 99219 |
|
151 |
131 |
$15K |
| 90633 |
|
4,103 |
4,086 |
$14K |
| 90744 |
|
2,300 |
2,292 |
$13K |
| 90677 |
|
2,068 |
2,061 |
$12K |
| D8670 |
Periodic orthodontic treatment visit |
257 |
243 |
$11K |
| 90697 |
|
4,099 |
3,875 |
$11K |
| 90620 |
|
1,052 |
961 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
750 |
721 |
$7K |
| 90716 |
|
1,873 |
1,870 |
$7K |
| 90707 |
|
1,746 |
1,744 |
$6K |
| 99442 |
|
239 |
217 |
$6K |
| 90651 |
|
1,760 |
1,719 |
$6K |
| 90734 |
|
1,176 |
1,175 |
$6K |
| 90710 |
|
1,402 |
1,395 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
329 |
311 |
$5K |
| 81025 |
|
917 |
894 |
$4K |
| 90696 |
|
1,321 |
1,313 |
$4K |
| 90715 |
|
1,081 |
1,063 |
$4K |
| 0071A |
|
83 |
82 |
$3K |
| 96161 |
|
3,314 |
3,199 |
$3K |
| 90656 |
|
776 |
776 |
$3K |
| 99477 |
|
12 |
12 |
$3K |
| 83655 |
|
491 |
478 |
$3K |
| 99441 |
|
105 |
102 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
109 |
105 |
$2K |
| 0124A |
|
51 |
51 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
19 |
17 |
$2K |
| D0330 |
Panoramic radiographic image |
64 |
61 |
$2K |
| 90649 |
|
191 |
191 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
99 |
94 |
$2K |
| D1110 |
Prophylaxis - adult |
58 |
56 |
$2K |
| 99384 |
|
15 |
15 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
41 |
39 |
$1K |
| 0072A |
|
28 |
28 |
$1K |
| 99383 |
|
12 |
12 |
$766.96 |
| 99217 |
|
12 |
12 |
$742.48 |
| D0274 |
Bitewings - four radiographic images |
33 |
32 |
$705.60 |
| D0220 |
Intraoral - periapical first radiographic image |
100 |
92 |
$692.80 |
| 0051A |
|
15 |
15 |
$629.86 |
| 99000 |
|
10,562 |
10,196 |
$542.60 |
| 0052A |
|
13 |
13 |
$528.00 |
| 90619 |
|
285 |
285 |
$519.13 |
| D0120 |
Periodic oral evaluation - established patient |
27 |
27 |
$486.00 |
| G0008 |
Administration of influenza virus vaccine |
47 |
39 |
$343.49 |
| 90700 |
|
118 |
117 |
$231.50 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$217.80 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
29 |
24 |
$211.84 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$189.58 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
28 |
26 |
$189.45 |
| 88720 |
|
40 |
40 |
$180.06 |
| D0270 |
|
13 |
13 |
$86.40 |
| 90688 |
|
12 |
12 |
$70.00 |
| 96160 |
|
77 |
76 |
$39.24 |
| 90713 |
|
125 |
124 |
$14.00 |
| 36416 |
|
303 |
298 |
$2.50 |
| G9920 |
Screening performed and negative |
2,549 |
2,298 |
$0.94 |
| G9919 |
Screening performed and positive and provision of recommendations |
40 |
40 |
$0.06 |
| C3000 |
|
18 |
17 |
$0.00 |
| 91322 |
|
14 |
14 |
$0.00 |
| 90682 |
|
115 |
114 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
13 |
13 |
$0.00 |