| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
78,497 |
67,272 |
$131K |
| D1110 |
Prophylaxis - adult |
1,688 |
1,517 |
$37K |
| 0004A |
|
643 |
636 |
$22K |
| 0072A |
|
560 |
560 |
$22K |
| 0071A |
|
538 |
537 |
$21K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,228 |
1,097 |
$19K |
| D0272 |
Bitewings - two radiographic images |
1,503 |
1,367 |
$18K |
| 99442 |
|
3,869 |
3,468 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
24,212 |
22,505 |
$16K |
| 0002A |
|
461 |
422 |
$16K |
| D0330 |
Panoramic radiographic image |
606 |
551 |
$14K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,353 |
1,015 |
$13K |
| D0120 |
Periodic oral evaluation - established patient |
1,171 |
1,069 |
$13K |
| D1208 |
Topical application of fluoride, excluding varnish |
913 |
796 |
$12K |
| 99441 |
|
11,055 |
10,058 |
$12K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
400 |
299 |
$12K |
| D1999 |
|
905 |
815 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,682 |
1,970 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,364 |
2,155 |
$10K |
| 0064A |
|
268 |
248 |
$10K |
| D1120 |
Prophylaxis - child |
580 |
493 |
$9K |
| 0001A |
|
325 |
293 |
$9K |
| D2140 |
|
383 |
271 |
$9K |
| S9083 |
Global fee urgent care centers |
792 |
764 |
$8K |
| D7140 |
Extraction, erupted tooth or exposed root |
255 |
166 |
$7K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
311 |
225 |
$7K |
| 0012A |
|
161 |
161 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
431 |
368 |
$5K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
520 |
519 |
$5K |
| 93000 |
|
1,480 |
1,420 |
$5K |
| 0054A |
|
113 |
113 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,482 |
739 |
$3K |
| 0003A |
|
76 |
76 |
$3K |
| 0011A |
|
71 |
67 |
$3K |
| 0124A |
|
51 |
51 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
935 |
881 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
361 |
325 |
$2K |
| 99443 |
|
58 |
53 |
$1K |
| 97802 |
|
36 |
36 |
$1K |
| 90649 |
|
373 |
236 |
$852.06 |
| 96152 |
|
618 |
520 |
$673.92 |
| 99201 |
|
20 |
20 |
$654.60 |
| 99368 |
|
84 |
76 |
$625.00 |
| 90461 |
|
827 |
433 |
$607.38 |
| 0081A |
|
15 |
15 |
$600.00 |
| 0111A |
|
15 |
14 |
$560.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
138 |
85 |
$495.67 |
| 80061 |
Lipid panel |
1,468 |
1,422 |
$453.36 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
180 |
178 |
$403.68 |
| 0094A |
|
14 |
14 |
$400.00 |
| 90734 |
|
93 |
58 |
$338.79 |
| 80053 |
Comprehensive metabolic panel |
984 |
931 |
$309.95 |
| 84443 |
Thyroid stimulating hormone (TSH) |
1,355 |
1,317 |
$233.84 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
492 |
456 |
$201.64 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
594 |
576 |
$188.93 |
| 76641 |
|
396 |
394 |
$187.60 |
| 96127 |
|
3,748 |
3,673 |
$157.12 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
165 |
164 |
$155.00 |
| 96160 |
|
2,722 |
2,684 |
$124.17 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,027 |
1,951 |
$119.88 |
| 71046 |
Radiologic examination, chest; 2 views |
78 |
71 |
$109.08 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
24 |
24 |
$100.38 |
| 81000 |
|
1,796 |
1,727 |
$94.66 |
| 71045 |
Radiologic examination, chest; single view |
182 |
181 |
$81.96 |
| 76830 |
Ultrasound, transvaginal |
181 |
180 |
$77.06 |
| 86592 |
|
489 |
482 |
$68.32 |
| 86701 |
|
469 |
464 |
$60.94 |
| 84439 |
|
273 |
258 |
$57.73 |
| 90658 |
|
828 |
491 |
$55.60 |
| 90633 |
|
273 |
185 |
$54.00 |
| 84153 |
|
44 |
43 |
$47.70 |
| 92558 |
|
2,397 |
2,365 |
$41.70 |
| 80050 |
General health panel |
550 |
544 |
$39.78 |
| 90655 |
|
226 |
121 |
$31.60 |
| 90700 |
|
874 |
528 |
$30.00 |
| 90713 |
|
662 |
391 |
$30.00 |
| 90648 |
|
641 |
366 |
$30.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
235 |
233 |
$25.31 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
32 |
32 |
$24.09 |
| 90670 |
|
318 |
223 |
$24.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
348 |
336 |
$23.67 |
| 99173 |
|
3,504 |
3,396 |
$22.40 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
720 |
707 |
$21.43 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
35 |
31 |
$15.00 |
| 96150 |
|
1,004 |
993 |
$13.79 |
| 99406 |
|
466 |
445 |
$12.50 |
| 87088 |
|
79 |
79 |
$12.48 |
| 82274 |
|
210 |
209 |
$12.25 |
| 90671 |
|
237 |
97 |
$12.00 |
| 90744 |
|
167 |
79 |
$12.00 |
| 90680 |
|
31 |
13 |
$12.00 |
| 3008F |
|
66,939 |
61,555 |
$5.00 |
| 3074F |
|
52,858 |
48,792 |
$4.00 |
| 3078F |
|
50,001 |
46,335 |
$2.00 |
| 3351F |
|
6,331 |
6,172 |
$2.00 |
| 3725F |
|
9,193 |
8,949 |
$1.00 |
| 3079F |
|
11,073 |
10,497 |
$1.00 |
| 1126F |
|
25,089 |
23,527 |
$1.00 |
| 1159F |
|
56,604 |
52,154 |
$0.00 |
| 1160F |
|
46,947 |
43,184 |
$0.00 |
| 1033F |
|
13,862 |
12,615 |
$0.00 |
| 0521F |
|
3,844 |
3,553 |
$0.00 |
| 3077F |
|
3,958 |
3,731 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,161 |
2,758 |
$0.00 |
| 4040F |
|
8,155 |
7,545 |
$0.00 |
| 1039F |
|
114 |
98 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
220 |
203 |
$0.00 |
| 4013F |
|
1,162 |
1,109 |
$0.00 |
| 2028F |
|
76 |
67 |
$0.00 |
| 90707 |
|
127 |
82 |
$0.00 |
| 3015F |
|
554 |
485 |
$0.00 |
| 99401 |
|
1,109 |
989 |
$0.00 |
| 90621 |
|
12 |
12 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
307 |
300 |
$0.00 |
| 99411 |
|
361 |
292 |
$0.00 |
| 3051F |
|
39 |
38 |
$0.00 |
| 72100 |
|
74 |
74 |
$0.00 |
| 4004F |
|
837 |
833 |
$0.00 |
| 99421 |
|
302 |
273 |
$0.00 |
| 87275 |
|
45 |
45 |
$0.00 |
| 99408 |
|
112 |
98 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
51 |
51 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
42 |
42 |
$0.00 |
| 82947 |
|
12 |
12 |
$0.00 |
| 2014F |
|
14 |
14 |
$0.00 |
| 3050F |
|
25 |
25 |
$0.00 |
| 3342F |
|
12 |
12 |
$0.00 |
| 90715 |
|
21 |
13 |
$0.00 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$0.00 |
| 3075F |
|
3,018 |
2,920 |
$0.00 |
| 90716 |
|
144 |
98 |
$0.00 |
| 4037F |
|
11,735 |
10,920 |
$0.00 |
| 1000F |
|
1,845 |
1,663 |
$0.00 |
| 3049F |
|
184 |
184 |
$0.00 |
| 1111F |
|
468 |
464 |
$0.00 |
| 1036F |
|
3,082 |
2,823 |
$0.00 |
| 1125F |
|
10,087 |
9,481 |
$0.00 |
| 2010F |
|
3,323 |
3,033 |
$0.00 |
| 90619 |
|
142 |
89 |
$0.00 |
| 3061F |
|
326 |
326 |
$0.00 |
| 99422 |
|
533 |
508 |
$0.00 |
| 3017F |
|
133 |
131 |
$0.00 |
| 4010F |
|
1,276 |
1,211 |
$0.00 |
| 3048F |
|
1,041 |
1,037 |
$0.00 |
| 1157F |
|
809 |
803 |
$0.00 |
| 99050 |
|
275 |
264 |
$0.00 |
| 82043 |
|
83 |
82 |
$0.00 |
| 2000F |
|
3,332 |
3,031 |
$0.00 |
| 96151 |
|
101 |
92 |
$0.00 |
| 3080F |
|
293 |
282 |
$0.00 |
| 96156 |
|
52 |
43 |
$0.00 |
| 3044F |
|
303 |
296 |
$0.00 |
| 1034F |
|
120 |
105 |
$0.00 |
| 87276 |
|
45 |
45 |
$0.00 |
| 90677 |
|
79 |
61 |
$0.00 |
| 1220F |
|
121 |
121 |
$0.00 |
| 3014F |
|
93 |
88 |
$0.00 |
| 3066F |
|
29 |
29 |
$0.00 |
| 1110F |
|
130 |
122 |
$0.00 |
| 2001F |
|
3,327 |
3,031 |
$0.00 |
| 3354F |
|
26 |
26 |
$0.00 |
| 90697 |
|
12 |
12 |
$0.00 |
| 76536 |
|
12 |
12 |
$0.00 |
| 1030F |
|
13 |
12 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
17 |
$0.00 |
| 92551 |
|
12 |
12 |
$0.00 |
| 1170F |
|
31 |
26 |
$0.00 |