| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
110,707 |
97,062 |
$3.62M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
83,082 |
72,969 |
$3.14M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,155 |
3,661 |
$310K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,909 |
3,640 |
$304K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
4,649 |
3,438 |
$280K |
| D0330 |
Panoramic radiographic image |
3,129 |
3,110 |
$274K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,796 |
2,637 |
$205K |
| D1120 |
Prophylaxis - child |
6,272 |
6,097 |
$162K |
| D1110 |
Prophylaxis - adult |
4,274 |
4,075 |
$159K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
5,181 |
4,996 |
$145K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
1,019 |
854 |
$128K |
| H1000 |
Prenatal care, at-risk assessment |
2,321 |
1,602 |
$125K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
22,917 |
21,314 |
$111K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,314 |
1,248 |
$103K |
| D0120 |
Periodic oral evaluation - established patient |
5,958 |
5,702 |
$70K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,795 |
1,487 |
$69K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,574 |
1,107 |
$66K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
9,911 |
9,027 |
$63K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
4,884 |
4,434 |
$60K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
2,971 |
1,582 |
$55K |
| D0210 |
Intraoral - complete series of radiographic images |
767 |
661 |
$50K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
5,103 |
4,828 |
$45K |
| D7111 |
|
1,121 |
833 |
$40K |
| D1351 |
Sealant - per tooth |
7,672 |
2,268 |
$38K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
623 |
541 |
$37K |
| D1206 |
Topical application of fluoride varnish |
10,995 |
10,582 |
$37K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
2,020 |
1,839 |
$35K |
| 36415 |
Collection of venous blood by venipuncture |
15,345 |
14,138 |
$30K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
419 |
378 |
$27K |
| 90671 |
|
453 |
400 |
$27K |
| D0274 |
Bitewings - four radiographic images |
4,112 |
3,986 |
$24K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,370 |
3,094 |
$24K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
368 |
351 |
$23K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
310 |
255 |
$22K |
| D0140 |
Limited oral evaluation - problem focused |
1,499 |
1,468 |
$20K |
| 99188 |
|
2,072 |
1,966 |
$19K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
251 |
184 |
$18K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,740 |
1,675 |
$15K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
561 |
475 |
$15K |
| 90697 |
|
371 |
343 |
$10K |
| D0603 |
|
9,736 |
9,322 |
$8K |
| D0272 |
Bitewings - two radiographic images |
5,449 |
5,322 |
$8K |
| D9999 |
Unspecified adjunctive procedure, by report |
303 |
303 |
$6K |
| 3074F |
|
57,914 |
52,219 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
2,538 |
2,403 |
$5K |
| D2931 |
|
51 |
49 |
$4K |
| 81002 |
|
4,583 |
3,876 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,101 |
763 |
$4K |
| 99215 |
Prolong outpt/office vis |
72 |
67 |
$4K |
| 81025 |
|
512 |
484 |
$3K |
| D0145 |
Oral evaluation for a patient under three years of age |
155 |
140 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,726 |
1,467 |
$2K |
| 99385 |
|
44 |
37 |
$2K |
| D1999 |
|
38 |
38 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
207 |
190 |
$2K |
| 90619 |
|
46 |
46 |
$2K |
| D1330 |
|
11,050 |
10,634 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
897 |
482 |
$1K |
| 0001A |
|
37 |
36 |
$1K |
| 3075F |
|
12,180 |
11,225 |
$1K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
393 |
320 |
$1K |
| D0999 |
Unspecified diagnostic procedure, by report |
53 |
53 |
$1K |
| 99381 |
|
14 |
13 |
$1K |
| D2332 |
|
17 |
12 |
$916.27 |
| 90651 |
|
651 |
622 |
$760.51 |
| 0002A |
|
20 |
20 |
$760.00 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
5,362 |
4,175 |
$591.59 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
631 |
597 |
$567.05 |
| 90686 |
|
5,294 |
5,142 |
$495.16 |
| 0031A |
|
31 |
26 |
$456.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,044 |
1,004 |
$446.48 |
| D2330 |
|
16 |
13 |
$411.55 |
| 85018 |
|
659 |
617 |
$301.51 |
| 3077F |
|
3,140 |
2,723 |
$288.69 |
| 90674 |
|
409 |
404 |
$210.00 |
| 90670 |
|
851 |
823 |
$180.05 |
| 92551 |
|
285 |
284 |
$177.50 |
| 91300 |
|
79 |
75 |
$160.00 |
| 90480 |
|
12 |
12 |
$160.00 |
| D0602 |
|
354 |
345 |
$153.00 |
| 3078F |
|
62,532 |
54,302 |
$146.64 |
| D0601 |
|
201 |
178 |
$100.00 |
| 90633 |
|
449 |
429 |
$84.48 |
| 90656 |
|
421 |
397 |
$78.13 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
133 |
118 |
$77.60 |
| 99173 |
|
297 |
294 |
$48.02 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
214 |
162 |
$40.04 |
| 87634 |
|
29 |
28 |
$9.60 |
| 82044 |
|
18 |
16 |
$7.76 |
| 94760 |
|
1,014 |
861 |
$2.50 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
25 |
25 |
$0.59 |
| 90672 |
|
57 |
57 |
$0.00 |
| 90715 |
|
87 |
87 |
$0.00 |
| 90734 |
|
25 |
25 |
$0.00 |
| 90710 |
|
94 |
80 |
$0.00 |
| 90681 |
|
13 |
13 |
$0.00 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
13 |
12 |
$0.00 |
| 87420 |
|
12 |
12 |
$0.00 |
| 3079F |
|
16,344 |
14,599 |
$0.00 |
| 3080F |
|
653 |
598 |
$0.00 |
| 90698 |
|
415 |
404 |
$0.00 |
| 90680 |
|
77 |
74 |
$0.00 |
| 1111F |
|
50 |
41 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
12 |
12 |
$0.00 |
| 90660 |
|
20 |
20 |
$0.00 |
| 90620 |
|
32 |
29 |
$0.00 |
| 90744 |
|
67 |
67 |
$0.00 |
| 99000 |
|
15 |
15 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
28 |
27 |
$0.00 |