| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,063 |
10,078 |
$1.36M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,451 |
1,215 |
$178K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,330 |
1,197 |
$156K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
656 |
593 |
$83K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
608 |
540 |
$70K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
443 |
422 |
$58K |
| D0999 |
Unspecified diagnostic procedure, by report |
324 |
301 |
$49K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
328 |
284 |
$39K |
| D0140 |
Limited oral evaluation - problem focused |
724 |
590 |
$31K |
| D1206 |
Topical application of fluoride varnish |
1,483 |
1,319 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
581 |
516 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
103 |
98 |
$12K |
| D1120 |
Prophylaxis - child |
1,127 |
1,004 |
$12K |
| D0120 |
Periodic oral evaluation - established patient |
206 |
192 |
$6K |
| 99384 |
|
43 |
41 |
$5K |
| 90649 |
|
189 |
167 |
$5K |
| 99215 |
Prolong outpt/office vis |
60 |
45 |
$4K |
| 99205 |
Prolong outpt/office vis |
54 |
33 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
29 |
25 |
$3K |
| 83655 |
|
1,355 |
1,068 |
$3K |
| D0330 |
Panoramic radiographic image |
101 |
90 |
$3K |
| 0002A |
|
38 |
35 |
$789.14 |
| D0274 |
Bitewings - four radiographic images |
38 |
35 |
$673.13 |
| 0001A |
|
40 |
35 |
$430.44 |
| 99441 |
|
17 |
12 |
$374.74 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$361.70 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
122 |
90 |
$273.78 |
| 0071A |
|
21 |
17 |
$179.35 |
| 85018 |
|
2,553 |
2,226 |
$155.32 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
42 |
32 |
$140.11 |
| D0272 |
Bitewings - two radiographic images |
27 |
24 |
$101.50 |
| 90715 |
|
205 |
171 |
$96.17 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
846 |
608 |
$46.18 |
| 90677 |
|
161 |
135 |
$0.44 |
| 90723 |
|
412 |
356 |
$0.27 |
| 90680 |
|
326 |
277 |
$0.26 |
| 90633 |
|
454 |
383 |
$0.26 |
| 90716 |
|
322 |
266 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
381 |
280 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,309 |
2,901 |
$0.00 |
| 90732 |
|
27 |
27 |
$0.00 |
| 3079F |
|
523 |
444 |
$0.00 |
| 3008F |
|
6,020 |
4,458 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
350 |
318 |
$0.00 |
| 3074F |
|
4,885 |
3,746 |
$0.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
103 |
101 |
$0.00 |
| 92551 |
|
3,335 |
2,740 |
$0.00 |
| 85027 |
|
44 |
27 |
$0.00 |
| 90620 |
|
47 |
40 |
$0.00 |
| 99000 |
|
1,448 |
1,208 |
$0.00 |
| 1125F |
|
362 |
296 |
$0.00 |
| 1126F |
|
4,344 |
3,438 |
$0.00 |
| 90651 |
|
333 |
272 |
$0.00 |
| 90688 |
|
178 |
154 |
$0.00 |
| 3075F |
|
27 |
13 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
17 |
14 |
$0.00 |
| 90696 |
|
41 |
40 |
$0.00 |
| 1000F |
|
570 |
511 |
$0.00 |
| 90697 |
|
52 |
48 |
$0.00 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
319 |
243 |
$0.00 |
| D0603 |
|
233 |
205 |
$0.00 |
| 97802 |
|
1,337 |
1,092 |
$0.00 |
| 90686 |
|
75 |
75 |
$0.00 |
| 90647 |
|
28 |
28 |
$0.00 |
| D1330 |
|
71 |
64 |
$0.00 |
| 96150 |
|
85 |
68 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
49 |
26 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
18 |
15 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
12 |
12 |
$0.00 |
| 36416 |
|
14 |
14 |
$0.00 |
| 99173 |
|
3,865 |
3,160 |
$0.00 |
| 1160F |
|
6,575 |
4,741 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,468 |
892 |
$0.00 |
| 90670 |
|
697 |
602 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
910 |
723 |
$0.00 |
| 3078F |
|
4,357 |
3,346 |
$0.00 |
| 90648 |
|
818 |
704 |
$0.00 |
| 3725F |
|
1,526 |
1,161 |
$0.00 |
| 90707 |
|
292 |
245 |
$0.00 |
| 1159F |
|
6,390 |
4,581 |
$0.00 |
| 90734 |
|
366 |
292 |
$0.00 |
| 81002 |
|
265 |
201 |
$0.00 |
| 90658 |
|
165 |
160 |
$0.00 |
| 80061 |
Lipid panel |
12 |
12 |
$0.00 |
| 81025 |
|
120 |
97 |
$0.00 |
| 90700 |
|
17 |
15 |
$0.00 |