| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24,805 |
21,641 |
$3.88M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18,052 |
16,499 |
$2.99M |
| D1120 |
Prophylaxis - child |
6,832 |
6,650 |
$977K |
| D1110 |
Prophylaxis - adult |
5,302 |
5,184 |
$811K |
| D0140 |
Limited oral evaluation - problem focused |
3,539 |
3,365 |
$589K |
| D0330 |
Panoramic radiographic image |
2,763 |
2,698 |
$466K |
| D7140 |
Extraction, erupted tooth or exposed root |
4,633 |
2,354 |
$427K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
3,626 |
2,599 |
$416K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,479 |
1,453 |
$293K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,440 |
1,282 |
$255K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,775 |
1,994 |
$245K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,119 |
1,103 |
$228K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,110 |
1,072 |
$220K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,226 |
1,190 |
$218K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
931 |
922 |
$182K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
925 |
886 |
$179K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,014 |
968 |
$158K |
| D1206 |
Topical application of fluoride varnish |
6,082 |
5,925 |
$148K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,726 |
2,644 |
$140K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
722 |
703 |
$124K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
798 |
761 |
$117K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
688 |
638 |
$111K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,575 |
2,284 |
$96K |
| D1351 |
Sealant - per tooth |
7,194 |
2,374 |
$91K |
| V2020 |
Frames, purchases |
2,102 |
2,052 |
$90K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
558 |
454 |
$90K |
| 90834 |
Psychotherapy, 45 minutes with patient |
430 |
385 |
$78K |
| D0274 |
Bitewings - four radiographic images |
3,594 |
3,518 |
$52K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
268 |
261 |
$50K |
| D1208 |
Topical application of fluoride, excluding varnish |
4,324 |
4,222 |
$23K |
| D0120 |
Periodic oral evaluation - established patient |
3,664 |
3,595 |
$22K |
| 99215 |
Prolong outpt/office vis |
103 |
97 |
$19K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
97 |
94 |
$15K |
| 99383 |
|
74 |
73 |
$14K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
75 |
56 |
$11K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
389 |
332 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
579 |
535 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
264 |
244 |
$8K |
| 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 |
9,291 |
7,144 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,625 |
6,413 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
118 |
117 |
$7K |
| 90832 |
Psychotherapy, 30 minutes with patient |
42 |
40 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
3,048 |
2,910 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
118 |
115 |
$5K |
| 90791 |
Psychiatric diagnostic evaluation |
32 |
32 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
188 |
178 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,015 |
2,908 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
831 |
768 |
$3K |
| 99382 |
|
13 |
13 |
$3K |
| 99384 |
|
12 |
12 |
$2K |
| V2760 |
Scratch resistant coating, per lens |
194 |
182 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
333 |
316 |
$2K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
14 |
12 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
174 |
170 |
$2K |
| 99381 |
|
14 |
12 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
880 |
776 |
$1K |
| 80053 |
Comprehensive metabolic panel |
471 |
419 |
$1K |
| 90670 |
|
619 |
580 |
$715.03 |
| 92015 |
Determination of refractive state |
3,533 |
3,368 |
$569.37 |
| D2330 |
|
15 |
12 |
$560.31 |
| D1354 |
|
15 |
15 |
$527.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
117 |
101 |
$440.14 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,126 |
1,044 |
$438.68 |
| 80061 |
Lipid panel |
143 |
123 |
$419.54 |
| 36415 |
Collection of venous blood by venipuncture |
7,672 |
7,068 |
$296.61 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
770 |
646 |
$276.50 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
184 |
173 |
$225.63 |
| 81002 |
|
224 |
197 |
$210.21 |
| D0272 |
Bitewings - two radiographic images |
2,009 |
1,961 |
$206.77 |
| 90686 |
|
2,315 |
2,262 |
$200.54 |
| 90688 |
|
184 |
171 |
$123.76 |
| 90662 |
|
31 |
31 |
$79.21 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
103 |
92 |
$34.29 |
| 90633 |
|
360 |
347 |
$0.00 |
| 90671 |
|
411 |
398 |
$0.00 |
| 3078F |
|
500 |
468 |
$0.00 |
| D0191 |
|
3,554 |
3,446 |
$0.00 |
| 92568 |
|
177 |
171 |
$0.00 |
| 90715 |
|
369 |
356 |
$0.00 |
| 90710 |
|
226 |
217 |
$0.00 |
| 90734 |
|
236 |
231 |
$0.00 |
| 90682 |
|
122 |
113 |
$0.00 |
| 90687 |
|
66 |
60 |
$0.00 |
| 90473 |
|
20 |
15 |
$0.00 |
| 90621 |
|
47 |
45 |
$0.00 |
| 90681 |
|
19 |
13 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
32 |
32 |
$0.00 |
| 36416 |
|
1,048 |
994 |
$0.00 |
| 90619 |
|
190 |
187 |
$0.00 |
| 1111F |
|
563 |
533 |
$0.00 |
| 90474 |
|
205 |
200 |
$0.00 |
| 3074F |
|
466 |
442 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
207 |
184 |
$0.00 |
| 90744 |
|
33 |
30 |
$0.00 |
| 90651 |
|
499 |
484 |
$0.00 |
| 90697 |
|
123 |
118 |
$0.00 |
| 3075F |
|
135 |
124 |
$0.00 |
| 90698 |
|
353 |
331 |
$0.00 |
| 90620 |
|
93 |
93 |
$0.00 |
| 3044F |
|
83 |
82 |
$0.00 |
| 90680 |
|
188 |
184 |
$0.00 |
| 3079F |
|
144 |
136 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
28 |
28 |
$0.00 |
| 90696 |
|
81 |
80 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
15 |
13 |
$0.00 |
| 90656 |
|
41 |
41 |
$0.00 |
| D1355 |
|
132 |
29 |
$0.00 |