| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
53,477 |
47,117 |
$8.42M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
48,830 |
42,569 |
$7.61M |
| D0999 |
Unspecified diagnostic procedure, by report |
26,189 |
23,525 |
$6.99M |
| H0023 |
Behavioral health outreach service (planned approach to reach a targeted population) |
9,263 |
4,715 |
$494K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,469 |
2,251 |
$438K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
7,592 |
3,946 |
$401K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
912 |
857 |
$177K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
636 |
603 |
$125K |
| D1206 |
Topical application of fluoride varnish |
14,737 |
13,631 |
$102K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
394 |
385 |
$74K |
| D1354 |
|
4,524 |
1,141 |
$62K |
| D0120 |
Periodic oral evaluation - established patient |
6,144 |
5,780 |
$53K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
285 |
272 |
$52K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
17,291 |
16,322 |
$45K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
188 |
184 |
$38K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
157 |
146 |
$31K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
149 |
140 |
$29K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16,760 |
16,186 |
$29K |
| 36415 |
Collection of venous blood by venipuncture |
16,282 |
15,038 |
$25K |
| D1120 |
Prophylaxis - child |
1,743 |
1,628 |
$23K |
| D0272 |
Bitewings - two radiographic images |
2,000 |
1,846 |
$22K |
| D0274 |
Bitewings - four radiographic images |
1,452 |
1,352 |
$17K |
| H0025 |
Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) |
317 |
255 |
$17K |
| D0330 |
Panoramic radiographic image |
618 |
562 |
$15K |
| D1351 |
Sealant - per tooth |
1,256 |
384 |
$14K |
| D0190 |
|
3,127 |
2,918 |
$13K |
| 99000 |
|
22,634 |
20,633 |
$13K |
| D1110 |
Prophylaxis - adult |
474 |
424 |
$12K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
421 |
356 |
$9K |
| D0220 |
Intraoral - periapical first radiographic image |
1,679 |
1,557 |
$9K |
| 0012A |
|
242 |
232 |
$8K |
| D0145 |
Oral evaluation for a patient under three years of age |
863 |
819 |
$7K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
184 |
89 |
$7K |
| 0011A |
|
248 |
214 |
$7K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
87 |
55 |
$7K |
| D1353 |
|
171 |
58 |
$6K |
| 99215 |
Prolong outpt/office vis |
28 |
28 |
$5K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
667 |
567 |
$5K |
| 36416 |
|
4,442 |
4,191 |
$4K |
| 0002A |
|
96 |
91 |
$4K |
| 81002 |
|
6,321 |
4,967 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
551 |
512 |
$3K |
| 99349 |
|
13 |
12 |
$2K |
| 0001A |
|
80 |
57 |
$2K |
| 90651 |
|
63 |
55 |
$2K |
| 90686 |
|
5,705 |
5,537 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
48 |
32 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
173 |
151 |
$2K |
| 0072A |
|
31 |
31 |
$1K |
| 0071A |
|
28 |
27 |
$1K |
| D2940 |
|
34 |
13 |
$1K |
| 81025 |
|
269 |
244 |
$886.88 |
| 0004A |
|
19 |
19 |
$782.42 |
| 90834 |
Psychotherapy, 45 minutes with patient |
16 |
12 |
$632.39 |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
19 |
12 |
$542.00 |
| 90670 |
|
393 |
381 |
$540.02 |
| D0210 |
Intraoral - complete series of radiographic images |
12 |
12 |
$532.00 |
| 0054A |
|
12 |
12 |
$494.16 |
| 90734 |
|
26 |
25 |
$323.14 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,889 |
3,760 |
$296.86 |
| 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 |
27 |
24 |
$263.44 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
843 |
515 |
$229.96 |
| 90677 |
|
40 |
40 |
$197.90 |
| 85018 |
|
129 |
124 |
$14.94 |
| 80053 |
Comprehensive metabolic panel |
743 |
724 |
$14.78 |
| 90680 |
|
159 |
158 |
$0.02 |
| 90723 |
|
211 |
209 |
$0.02 |
| 83655 |
|
190 |
187 |
$0.00 |
| 90713 |
|
53 |
51 |
$0.00 |
| 80061 |
Lipid panel |
579 |
563 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
150 |
147 |
$0.00 |
| 86682 |
|
28 |
26 |
$0.00 |
| 90700 |
|
31 |
31 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
239 |
229 |
$0.00 |
| D0270 |
|
15 |
15 |
$0.00 |
| 90473 |
|
54 |
54 |
$0.00 |
| 90715 |
|
113 |
110 |
$0.00 |
| 99173 |
|
21 |
18 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 90633 |
|
100 |
99 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
285 |
277 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,244 |
2,151 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
857 |
829 |
$0.00 |
| 90647 |
|
184 |
182 |
$0.00 |
| 86592 |
|
146 |
141 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
264 |
259 |
$0.00 |
| 90688 |
|
1,694 |
1,663 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
219 |
212 |
$0.00 |
| 91301 |
|
471 |
457 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
107 |
102 |
$0.00 |
| 86803 |
|
363 |
351 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
419 |
407 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
26 |
24 |
$0.00 |
| 90716 |
|
13 |
13 |
$0.00 |
| 87340 |
|
95 |
94 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
27 |
27 |
$0.00 |
| 90656 |
|
64 |
64 |
$0.00 |
| 86317 |
|
119 |
118 |
$0.00 |
| 76801 |
|
12 |
12 |
$0.00 |
| 90474 |
|
54 |
53 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
17 |
12 |
$0.00 |