| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
148,159 |
103,203 |
$8.49M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
60,881 |
47,420 |
$4.89M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,680 |
4,381 |
$448K |
| D1110 |
Prophylaxis - adult |
8,144 |
6,916 |
$406K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,404 |
3,530 |
$364K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,160 |
3,158 |
$341K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
10,917 |
10,882 |
$325K |
| D0330 |
Panoramic radiographic image |
11,849 |
5,625 |
$292K |
| D1120 |
Prophylaxis - child |
11,466 |
6,191 |
$282K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,602 |
2,036 |
$201K |
| D0120 |
Periodic oral evaluation - established patient |
8,078 |
6,581 |
$191K |
| 99442 |
|
5,536 |
5,098 |
$176K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
10,488 |
9,762 |
$150K |
| D0274 |
Bitewings - four radiographic images |
5,847 |
4,075 |
$145K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,078 |
2,523 |
$132K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,907 |
7,849 |
$130K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,724 |
1,160 |
$104K |
| 99443 |
|
1,612 |
1,479 |
$85K |
| D1206 |
Topical application of fluoride varnish |
3,102 |
3,048 |
$82K |
| 90837 |
Psychotherapy, 53 minutes with patient |
837 |
626 |
$80K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,004 |
743 |
$78K |
| D0140 |
Limited oral evaluation - problem focused |
3,388 |
2,379 |
$77K |
| 99051 |
|
9,203 |
8,863 |
$74K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
979 |
718 |
$69K |
| 92002 |
|
1,123 |
1,042 |
$67K |
| 11721 |
|
1,650 |
1,404 |
$66K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,630 |
891 |
$63K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,408 |
2,064 |
$59K |
| 90686 |
|
3,575 |
3,574 |
$58K |
| 92551 |
|
7,065 |
7,064 |
$55K |
| D1351 |
Sealant - per tooth |
1,690 |
460 |
$48K |
| 99441 |
|
1,927 |
1,780 |
$46K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,498 |
1,498 |
$43K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,012 |
2,958 |
$42K |
| 92015 |
Determination of refractive state |
1,706 |
1,365 |
$33K |
| D0220 |
Intraoral - periapical first radiographic image |
2,208 |
2,179 |
$30K |
| 81025 |
|
4,394 |
4,256 |
$29K |
| D0272 |
Bitewings - two radiographic images |
1,663 |
1,626 |
$29K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
690 |
416 |
$28K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
536 |
312 |
$26K |
| 86703 |
|
1,817 |
1,807 |
$26K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
545 |
320 |
$26K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,958 |
1,958 |
$25K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,301 |
1,301 |
$23K |
| 90832 |
Psychotherapy, 30 minutes with patient |
403 |
314 |
$18K |
| 99173 |
|
6,589 |
6,346 |
$16K |
| D0145 |
Oral evaluation for a patient under three years of age |
816 |
297 |
$16K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,442 |
1,118 |
$16K |
| 0011A |
|
444 |
444 |
$15K |
| 0012A |
|
418 |
418 |
$15K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
150 |
126 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
161 |
160 |
$13K |
| S0612 |
Annual gynecological examination, established patient |
158 |
122 |
$13K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,170 |
1,167 |
$12K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
88 |
78 |
$10K |
| 96127 |
|
2,352 |
2,292 |
$10K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
165 |
122 |
$8K |
| 0064A |
|
221 |
221 |
$8K |
| 81000 |
|
2,550 |
2,514 |
$8K |
| 87806 |
|
321 |
320 |
$8K |
| 0001A |
|
199 |
199 |
$8K |
| 87210 |
|
1,440 |
1,434 |
$7K |
| 0002A |
|
160 |
160 |
$6K |
| 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 |
303 |
179 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
498 |
496 |
$5K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
104 |
101 |
$5K |
| 90791 |
Psychiatric diagnostic evaluation |
56 |
51 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
41 |
41 |
$4K |
| 99215 |
Prolong outpt/office vis |
28 |
27 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
190 |
179 |
$3K |
| D1354 |
|
441 |
159 |
$3K |
| 91322 |
|
25 |
25 |
$3K |
| 0071A |
|
77 |
76 |
$3K |
| 99406 |
|
210 |
193 |
$3K |
| 0004A |
|
63 |
63 |
$2K |
| 0134A |
|
57 |
57 |
$2K |
| 99401 |
|
98 |
95 |
$2K |
| 82962 |
|
462 |
454 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
20 |
13 |
$1K |
| 0072A |
|
28 |
28 |
$1K |
| 90480 |
|
39 |
39 |
$1K |
| 0502F |
|
16 |
12 |
$960.00 |
| 36415 |
Collection of venous blood by venipuncture |
460 |
458 |
$845.20 |
| 0031A |
|
37 |
37 |
$690.44 |
| D9990 |
|
54 |
53 |
$627.00 |
| 90658 |
|
44 |
44 |
$591.00 |
| 82948 |
|
157 |
151 |
$573.44 |
| 90630 |
|
29 |
29 |
$539.99 |
| 97802 |
|
24 |
24 |
$400.54 |
| 81002 |
|
172 |
170 |
$312.28 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
242 |
233 |
$301.76 |
| 97803 |
|
14 |
12 |
$270.82 |
| 94760 |
|
432 |
431 |
$171.90 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
12 |
12 |
$170.92 |
| D0210 |
Intraoral - complete series of radiographic images |
13 |
13 |
$126.00 |
| 90474 |
|
12 |
12 |
$119.46 |
| 96160 |
|
107 |
107 |
$84.28 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
83 |
83 |
$40.36 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
13 |
13 |
$11.00 |
| D9999 |
Unspecified adjunctive procedure, by report |
135 |
132 |
$0.00 |