| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99051 |
|
6,392 |
5,604 |
$599K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,068 |
962 |
$353K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
740 |
653 |
$222K |
| 70450 |
Computed tomography, head or brain; without contrast material |
303 |
268 |
$46K |
| 71046 |
Radiologic examination, chest; 2 views |
6,503 |
5,111 |
$41K |
| 72100 |
|
1,822 |
1,422 |
$10K |
| 74018 |
|
1,764 |
1,343 |
$6K |
| 72040 |
|
1,031 |
817 |
$5K |
| 86328 |
|
665 |
498 |
$4K |
| D0330 |
Panoramic radiographic image |
212 |
206 |
$4K |
| D1110 |
Prophylaxis - adult |
232 |
226 |
$3K |
| 0031A |
|
76 |
76 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
976 |
759 |
$3K |
| D0272 |
Bitewings - two radiographic images |
272 |
262 |
$3K |
| 73030 |
|
713 |
531 |
$3K |
| 0002A |
|
55 |
54 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
217 |
208 |
$2K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
126 |
125 |
$1K |
| 0001A |
|
60 |
57 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
132 |
128 |
$1K |
| 73564 |
|
346 |
234 |
$819.21 |
| 73620 |
|
365 |
256 |
$816.44 |
| 71045 |
Radiologic examination, chest; single view |
170 |
147 |
$675.08 |
| D0120 |
Periodic oral evaluation - established patient |
90 |
89 |
$629.46 |
| 73120 |
|
270 |
190 |
$565.55 |
| 73600 |
|
78 |
76 |
$546.24 |
| D1120 |
Prophylaxis - child |
30 |
30 |
$374.00 |
| 73610 |
|
142 |
87 |
$296.82 |
| 73630 |
|
195 |
95 |
$174.52 |
| 73560 |
|
74 |
46 |
$137.40 |
| 72080 |
|
236 |
147 |
$15.68 |
| 84703 |
|
70 |
69 |
$7.17 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
94 |
94 |
$0.01 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
642 |
439 |
$0.00 |
| 70260 |
|
130 |
75 |
$0.00 |
| 87899 |
|
225 |
215 |
$0.00 |
| 70250 |
|
46 |
27 |
$0.00 |
| 73100 |
|
51 |
25 |
$0.00 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
23 |
18 |
$0.00 |
| 73140 |
|
28 |
13 |
$0.00 |
| 73130 |
|
53 |
25 |
$0.00 |
| 73090 |
|
67 |
41 |
$0.00 |
| 70210 |
|
24 |
15 |
$0.00 |
| 83690 |
|
56 |
56 |
$0.00 |
| 70220 |
|
29 |
14 |
$0.00 |