| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,400 |
8,121 |
$859K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,475 |
1,008 |
$93K |
| D0999 |
Unspecified diagnostic procedure, by report |
3,015 |
582 |
$65K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
973 |
377 |
$42K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,164 |
407 |
$40K |
| D0120 |
Periodic oral evaluation - established patient |
2,677 |
382 |
$39K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
453 |
438 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
732 |
181 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
805 |
162 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
494 |
111 |
$11K |
| 0001A |
|
242 |
240 |
$10K |
| 0002A |
|
235 |
234 |
$9K |
| D1110 |
Prophylaxis - adult |
658 |
79 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
132 |
66 |
$6K |
| 99441 |
|
64 |
58 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
219 |
212 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
55 |
39 |
$5K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
102 |
39 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
150 |
40 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
37 |
29 |
$3K |
| 0003A |
|
69 |
69 |
$3K |
| D0140 |
Limited oral evaluation - problem focused |
58 |
15 |
$2K |
| 59425 |
|
21 |
14 |
$2K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
12 |
12 |
$29.83 |
| 91300 |
|
405 |
358 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
88 |
86 |
$0.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
22 |
19 |
$0.00 |