| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
32,999 |
28,456 |
$6.90M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,842 |
5,867 |
$1.20M |
| S0311 |
Comprehensive management and care coordination for advanced illness, per calendar month |
3,812 |
3,213 |
$856K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,293 |
2,258 |
$602K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,237 |
2,178 |
$577K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,398 |
2,280 |
$557K |
| D0210 |
Intraoral - complete series of radiographic images |
2,316 |
2,115 |
$427K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,556 |
1,529 |
$407K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
1,582 |
1,519 |
$399K |
| D1110 |
Prophylaxis - adult |
2,126 |
1,916 |
$368K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,580 |
1,498 |
$336K |
| D7140 |
Extraction, erupted tooth or exposed root |
3,472 |
1,253 |
$306K |
| D0140 |
Limited oral evaluation - problem focused |
1,518 |
1,359 |
$250K |
| D1206 |
Topical application of fluoride varnish |
2,667 |
2,421 |
$224K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,741 |
1,573 |
$208K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
772 |
744 |
$206K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
832 |
785 |
$178K |
| D0330 |
Panoramic radiographic image |
958 |
883 |
$171K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,503 |
3,194 |
$154K |
| 90837 |
Psychotherapy, 53 minutes with patient |
746 |
427 |
$128K |
| D0120 |
Periodic oral evaluation - established patient |
1,653 |
1,458 |
$128K |
| 96127 |
|
1,381 |
1,212 |
$91K |
| D0274 |
Bitewings - four radiographic images |
1,110 |
1,001 |
$80K |
| D1120 |
Prophylaxis - child |
705 |
619 |
$65K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
542 |
349 |
$63K |
| G9148 |
National committee for quality assurance - level 1 medical home |
678 |
631 |
$57K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
329 |
208 |
$38K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
593 |
522 |
$37K |
| S0221 |
Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 60 minutes |
413 |
406 |
$30K |
| 99406 |
|
1,788 |
1,579 |
$26K |
| 90834 |
Psychotherapy, 45 minutes with patient |
137 |
114 |
$26K |
| 99215 |
Prolong outpt/office vis |
144 |
131 |
$26K |
| D1351 |
Sealant - per tooth |
3,043 |
410 |
$25K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
86 |
81 |
$21K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
115 |
112 |
$19K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,462 |
4,296 |
$15K |
| 90756 |
|
485 |
454 |
$13K |
| 90791 |
Psychiatric diagnostic evaluation |
65 |
61 |
$11K |
| 99383 |
|
39 |
39 |
$9K |
| D0220 |
Intraoral - periapical first radiographic image |
1,580 |
1,385 |
$9K |
| 81002 |
|
1,162 |
1,029 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
249 |
247 |
$3K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
27 |
12 |
$2K |
| D4341 |
|
36 |
24 |
$2K |
| 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 |
5,858 |
4,311 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
722 |
454 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
41 |
41 |
$1K |
| 90785 |
|
635 |
339 |
$791.01 |
| 81025 |
|
118 |
113 |
$708.02 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
231 |
190 |
$549.60 |
| 90651 |
|
798 |
778 |
$522.65 |
| 82962 |
|
309 |
275 |
$503.15 |
| 90715 |
|
556 |
542 |
$467.47 |
| 90670 |
|
441 |
428 |
$268.65 |
| 90662 |
|
35 |
29 |
$183.10 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,680 |
2,168 |
$174.54 |
| 80305 |
|
29 |
25 |
$106.31 |
| 0071A |
|
15 |
13 |
$40.00 |
| 0011A |
|
39 |
29 |
$40.00 |
| 0012A |
|
37 |
27 |
$40.00 |
| 81001 |
|
33 |
33 |
$32.80 |
| 90656 |
|
268 |
259 |
$22.35 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
28 |
$11.26 |
| 90633 |
|
628 |
619 |
$0.00 |
| 81513 |
|
47 |
46 |
$0.00 |
| 90681 |
|
14 |
13 |
$0.00 |
| 90623 |
|
29 |
29 |
$0.00 |
| 90734 |
|
347 |
340 |
$0.00 |
| 3078F |
|
89 |
85 |
$0.00 |
| 90710 |
|
170 |
170 |
$0.00 |
| 90461 |
|
184 |
183 |
$0.00 |
| D0270 |
|
18 |
17 |
$0.00 |
| 90671 |
|
123 |
122 |
$0.00 |
| 90713 |
|
177 |
173 |
$0.00 |
| 90700 |
|
33 |
33 |
$0.00 |
| 91320 |
|
29 |
29 |
$0.00 |
| 97803 |
|
140 |
138 |
$0.00 |
| 0124A |
|
13 |
13 |
$0.00 |
| 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 |
19 |
14 |
$0.00 |
| 3008F |
|
5,684 |
5,391 |
$0.00 |
| 90686 |
|
915 |
892 |
$0.00 |
| 90716 |
|
82 |
81 |
$0.00 |
| 3074F |
|
92 |
87 |
$0.00 |
| 91307 |
|
16 |
14 |
$0.00 |
| 90744 |
|
121 |
119 |
$0.00 |
| 90619 |
|
158 |
152 |
$0.00 |
| 90480 |
|
35 |
34 |
$0.00 |
| 90698 |
|
81 |
78 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
41 |
41 |
$0.00 |
| 0154A |
|
12 |
12 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
13 |
13 |
$0.00 |
| 90697 |
|
45 |
44 |
$0.00 |
| 90696 |
|
43 |
43 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
18 |
18 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
17 |
16 |
$0.00 |
| 99000 |
|
40 |
40 |
$0.00 |
| 3079F |
|
35 |
33 |
$0.00 |
| 3075F |
|
14 |
14 |
$0.00 |
| 91301 |
|
71 |
53 |
$0.00 |
| D0603 |
|
35 |
34 |
$0.00 |