| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,621 |
7,742 |
$620K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,512 |
6,978 |
$475K |
| D7140 |
Extraction, erupted tooth or exposed root |
6,482 |
1,919 |
$343K |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,896 |
3,053 |
$322K |
| G9012 |
Other specified case management service not elsewhere classified |
1,317 |
1,283 |
$272K |
| D1110 |
Prophylaxis - adult |
4,883 |
4,752 |
$168K |
| D0330 |
Panoramic radiographic image |
3,731 |
2,941 |
$144K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,182 |
3,465 |
$94K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,127 |
1,601 |
$78K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,309 |
1,023 |
$63K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
2,528 |
1,106 |
$62K |
| D0220 |
Intraoral - periapical first radiographic image |
7,709 |
6,409 |
$57K |
| D0120 |
Periodic oral evaluation - established patient |
4,159 |
4,062 |
$55K |
| D0230 |
Intraoral - periapical each additional radiographic image |
6,995 |
3,215 |
$50K |
| D0140 |
Limited oral evaluation - problem focused |
2,989 |
2,195 |
$48K |
| 80305 |
|
3,976 |
2,390 |
$46K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
795 |
617 |
$46K |
| 90837 |
Psychotherapy, 53 minutes with patient |
464 |
291 |
$42K |
| D0274 |
Bitewings - four radiographic images |
2,394 |
2,314 |
$42K |
| D1206 |
Topical application of fluoride varnish |
2,142 |
2,114 |
$35K |
| 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 |
2,168 |
1,723 |
$32K |
| D1120 |
Prophylaxis - child |
1,180 |
1,166 |
$32K |
| D0210 |
Intraoral - complete series of radiographic images |
6,241 |
2,204 |
$22K |
| 90791 |
Psychiatric diagnostic evaluation |
203 |
189 |
$19K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
248 |
176 |
$11K |
| 3008F |
|
6,048 |
5,474 |
$11K |
| 36415 |
Collection of venous blood by venipuncture |
5,481 |
5,035 |
$10K |
| 99000 |
|
6,630 |
6,048 |
$9K |
| 96127 |
|
1,502 |
1,392 |
$7K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
39 |
37 |
$5K |
| 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 |
264 |
140 |
$5K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
53 |
38 |
$4K |
| 90674 |
|
198 |
187 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
792 |
725 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
262 |
250 |
$2K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
194 |
172 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
53 |
51 |
$1K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
14 |
12 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$851.07 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
37 |
24 |
$708.07 |
| 90756 |
|
42 |
36 |
$496.58 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
14 |
14 |
$472.36 |
| 99441 |
|
23 |
15 |
$396.69 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
14 |
$334.96 |
| D0270 |
|
27 |
26 |
$316.35 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$314.40 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
20 |
12 |
$294.54 |
| 90686 |
|
35 |
34 |
$273.62 |
| 81003 |
|
13 |
12 |
$24.97 |
| 96160 |
|
22 |
19 |
$6.12 |
| 36416 |
|
359 |
342 |
$3.07 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
205 |
190 |
$0.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
458 |
429 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
30 |
29 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
380 |
352 |
$0.00 |