| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96160 |
|
17,396 |
17,179 |
$447K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63,977 |
56,034 |
$360K |
| D1110 |
Prophylaxis - adult |
6,852 |
5,659 |
$193K |
| D1999 |
|
6,849 |
5,996 |
$102K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
2,538 |
2,116 |
$92K |
| D0120 |
Periodic oral evaluation - established patient |
6,421 |
5,315 |
$90K |
| 0002A |
|
2,223 |
2,052 |
$83K |
| 0001A |
|
2,222 |
2,070 |
$77K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,213 |
7,494 |
$69K |
| D0330 |
Panoramic radiographic image |
2,234 |
1,783 |
$67K |
| D0272 |
Bitewings - two radiographic images |
4,676 |
3,827 |
$66K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,840 |
3,533 |
$45K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,907 |
2,366 |
$41K |
| 0004A |
|
1,429 |
1,407 |
$34K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,745 |
1,402 |
$34K |
| D1120 |
Prophylaxis - child |
1,420 |
1,155 |
$27K |
| 0011A |
|
683 |
631 |
$25K |
| 0012A |
|
607 |
562 |
$23K |
| 97802 |
|
1,139 |
1,108 |
$22K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,357 |
3,219 |
$17K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
455 |
298 |
$16K |
| 0072A |
|
500 |
489 |
$15K |
| 99050 |
|
503 |
474 |
$14K |
| 0064A |
|
554 |
546 |
$14K |
| 0071A |
|
664 |
640 |
$10K |
| 97803 |
|
588 |
566 |
$10K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
315 |
287 |
$10K |
| D2140 |
|
325 |
181 |
$8K |
| 92015 |
Determination of refractive state |
752 |
566 |
$7K |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,192 |
3,009 |
$7K |
| D0140 |
Limited oral evaluation - problem focused |
327 |
308 |
$6K |
| 90732 |
|
535 |
474 |
$5K |
| 90658 |
|
1,445 |
1,392 |
$5K |
| 90656 |
|
539 |
487 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,426 |
329 |
$5K |
| D1351 |
Sealant - per tooth |
353 |
53 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
623 |
593 |
$4K |
| 0003A |
|
94 |
91 |
$4K |
| 0124A |
|
256 |
254 |
$3K |
| 99441 |
|
1,437 |
1,381 |
$3K |
| 92002 |
|
96 |
96 |
$3K |
| 90670 |
|
1,626 |
1,516 |
$3K |
| 90474 |
|
292 |
272 |
$2K |
| 0054A |
|
241 |
240 |
$2K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
42 |
41 |
$2K |
| D2160 |
|
38 |
30 |
$2K |
| 90649 |
|
609 |
577 |
$2K |
| 90715 |
|
1,136 |
1,062 |
$2K |
| 76830 |
Ultrasound, transvaginal |
41 |
41 |
$2K |
| 90734 |
|
1,321 |
1,242 |
$2K |
| 90648 |
|
769 |
717 |
$2K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
987 |
969 |
$2K |
| 90716 |
|
1,026 |
950 |
$1K |
| 90686 |
|
3,076 |
2,802 |
$1K |
| D3120 |
|
86 |
70 |
$1K |
| 76536 |
|
34 |
34 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
897 |
879 |
$1K |
| 90707 |
|
964 |
890 |
$1K |
| 90680 |
|
783 |
726 |
$1K |
| 99442 |
|
1,483 |
1,378 |
$1K |
| 90633 |
|
762 |
721 |
$1K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
175 |
157 |
$875.67 |
| 90698 |
|
284 |
266 |
$748.62 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
595 |
576 |
$739.63 |
| 99347 |
|
42 |
39 |
$601.00 |
| 90621 |
|
220 |
212 |
$576.36 |
| 90671 |
|
191 |
186 |
$537.76 |
| 90723 |
|
304 |
277 |
$536.69 |
| 93000 |
|
1,668 |
1,630 |
$533.54 |
| 90657 |
|
118 |
118 |
$472.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,442 |
1,408 |
$416.90 |
| 71046 |
Radiologic examination, chest; 2 views |
41 |
41 |
$405.33 |
| 97804 |
|
18 |
18 |
$219.06 |
| V2020 |
Frames, purchases |
188 |
130 |
$200.00 |
| 0134A |
|
64 |
64 |
$200.00 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$178.92 |
| 90696 |
|
175 |
152 |
$157.02 |
| G0008 |
Administration of influenza virus vaccine |
552 |
501 |
$140.94 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,603 |
1,573 |
$123.69 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
252 |
246 |
$121.81 |
| 0074A |
|
80 |
79 |
$120.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
57 |
56 |
$97.41 |
| 90651 |
|
1,116 |
1,059 |
$94.52 |
| 90700 |
|
30 |
30 |
$52.15 |
| 36415 |
Collection of venous blood by venipuncture |
455 |
432 |
$45.90 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
23 |
23 |
$45.23 |
| 90620 |
|
77 |
69 |
$40.41 |
| 90473 |
|
18 |
18 |
$40.00 |
| 1158F |
|
26 |
17 |
$40.00 |
| 0081A |
|
14 |
14 |
$40.00 |
| 96127 |
|
1,064 |
1,059 |
$28.40 |
| 99368 |
|
166 |
163 |
$24.37 |
| 3077F |
|
3,459 |
3,336 |
$21.00 |
| 86738 |
|
21 |
21 |
$18.76 |
| 90677 |
|
149 |
148 |
$0.22 |
| 90632 |
|
12 |
12 |
$0.12 |
| 90623 |
|
14 |
12 |
$0.02 |
| 1160F |
|
15,088 |
14,258 |
$0.00 |
| 4035F |
|
10,476 |
9,984 |
$0.00 |
| 1159F |
|
16,161 |
15,267 |
$0.00 |
| 85610 |
|
14 |
13 |
$0.00 |
| G0144 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision |
90 |
90 |
$0.00 |
| 91312 |
|
256 |
254 |
$0.00 |
| 3078F |
|
9,651 |
9,266 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,179 |
1,158 |
$0.00 |
| 90750 |
|
39 |
39 |
$0.00 |
| 76770 |
|
13 |
13 |
$0.00 |
| 82947 |
|
27 |
26 |
$0.00 |
| 80074 |
|
12 |
12 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
27 |
27 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
25 |
25 |
$0.00 |
| 99173 |
|
159 |
159 |
$0.00 |
| 91313 |
|
63 |
63 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
442 |
440 |
$0.00 |
| 90611 |
|
29 |
29 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
89 |
86 |
$0.00 |
| 91300 |
|
699 |
689 |
$0.00 |
| 3050F |
|
12 |
12 |
$0.00 |
| 3051F |
|
13 |
13 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
20 |
20 |
$0.00 |
| 80061 |
Lipid panel |
178 |
176 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
96 |
48 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
24 |
24 |
$0.00 |
| 3725F |
|
22 |
22 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
15 |
15 |
$0.00 |
| 91320 |
|
15 |
15 |
$0.00 |
| 91308 |
|
26 |
26 |
$0.00 |
| 82274 |
|
29 |
28 |
$0.00 |
| 84439 |
|
55 |
55 |
$0.00 |
| 3017F |
|
699 |
676 |
$0.00 |
| 3074F |
|
7,889 |
7,553 |
$0.00 |
| 1125F |
|
4,160 |
3,998 |
$0.00 |
| 3079F |
|
2,981 |
2,889 |
$0.00 |
| 1126F |
|
11,112 |
10,639 |
$0.00 |
| 3008F |
|
14,533 |
13,781 |
$0.00 |
| 3048F |
|
1,488 |
1,465 |
$0.00 |
| 3075F |
|
2,376 |
2,311 |
$0.00 |
| 3044F |
|
935 |
916 |
$0.00 |
| 3061F |
|
424 |
423 |
$0.00 |
| 3080F |
|
998 |
964 |
$0.00 |
| 81001 |
|
168 |
166 |
$0.00 |
| 3049F |
|
827 |
809 |
$0.00 |
| 91305 |
|
253 |
252 |
$0.00 |
| 82607 |
|
18 |
18 |
$0.00 |
| 1030F |
|
500 |
490 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
130 |
72 |
$0.00 |
| 91307 |
|
545 |
523 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
655 |
645 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
245 |
125 |
$0.00 |
| 1034F |
|
175 |
173 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
47 |
45 |
$0.00 |
| 1170F |
|
231 |
227 |
$0.00 |
| 3014F |
|
28 |
28 |
$0.00 |
| 82043 |
|
27 |
27 |
$0.00 |
| 90480 |
|
28 |
28 |
$0.00 |
| 90619 |
|
52 |
52 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
41 |
41 |
$0.00 |
| 99384 |
|
15 |
15 |
$0.00 |
| 86592 |
|
40 |
40 |
$0.00 |
| 1111F |
|
18 |
18 |
$0.00 |
| G2061 |
Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 5-10 minutes |
17 |
17 |
$0.00 |
| 84436 |
|
15 |
15 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
196 |
195 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
133 |
133 |
$0.00 |
| 87590 |
|
24 |
24 |
$0.00 |
| 1036F |
|
82 |
82 |
$0.00 |
| 91306 |
|
208 |
205 |
$0.00 |
| 86580 |
|
17 |
17 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
75 |
74 |
$0.00 |
| 3060F |
|
12 |
12 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
13 |
$0.00 |
| 99406 |
|
15 |
15 |
$0.00 |
| 90697 |
|
17 |
17 |
$0.00 |
| 86803 |
|
24 |
24 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
33 |
33 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
37 |
37 |
$0.00 |
| 87088 |
|
29 |
29 |
$0.00 |
| 85730 |
|
13 |
12 |
$0.00 |