| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
55,717 |
33,682 |
$20.30M |
| S9430 |
Pharmacy compounding and dispensing services |
38,863 |
22,609 |
$12.18M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15,126 |
11,117 |
$6.86M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
11,627 |
9,578 |
$5.58M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
11,684 |
9,766 |
$4.30M |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
3,161 |
2,824 |
$1.51M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,036 |
1,765 |
$849K |
| D1206 |
Topical application of fluoride varnish |
1,525 |
1,486 |
$736K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,548 |
1,412 |
$731K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,556 |
1,359 |
$651K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,276 |
1,200 |
$635K |
| D0220 |
Intraoral - periapical first radiographic image |
948 |
917 |
$447K |
| 0001A |
|
675 |
616 |
$299K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
651 |
633 |
$288K |
| 0002A |
|
578 |
551 |
$276K |
| D1120 |
Prophylaxis - child |
614 |
594 |
$252K |
| D1351 |
Sealant - per tooth |
444 |
431 |
$204K |
| 0071A |
|
284 |
282 |
$147K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
305 |
261 |
$145K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
196 |
190 |
$110K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
247 |
225 |
$96K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
174 |
171 |
$80K |
| 0072A |
|
140 |
134 |
$70K |
| D0274 |
Bitewings - four radiographic images |
111 |
111 |
$44K |
| D0140 |
Limited oral evaluation - problem focused |
80 |
77 |
$35K |
| D0330 |
Panoramic radiographic image |
88 |
87 |
$32K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
66 |
65 |
$31K |
| 0011A |
|
44 |
42 |
$21K |
| 0012A |
|
20 |
20 |
$10K |
| 90832 |
Psychotherapy, 30 minutes with patient |
53 |
46 |
$10K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
19 |
19 |
$9K |
| 90834 |
Psychotherapy, 45 minutes with patient |
34 |
25 |
$8K |
| 90837 |
Psychotherapy, 53 minutes with patient |
12 |
12 |
$8K |
| 0054A |
|
12 |
12 |
$7K |
| 0004A |
|
14 |
14 |
$7K |
| D0272 |
Bitewings - two radiographic images |
14 |
14 |
$6K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
12 |
12 |
$6K |
| 99441 |
|
21 |
20 |
$4K |
| 90651 |
|
31 |
31 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
56 |
56 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$0.00 |
| 90688 |
|
56 |
56 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 83655 |
|
16 |
16 |
$0.00 |
| 0124A |
|
18 |
18 |
$0.00 |