| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,828 |
13,418 |
$979K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,595 |
7,133 |
$826K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,363 |
2,277 |
$194K |
| 92551 |
|
4,525 |
4,307 |
$177K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,028 |
1,918 |
$168K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,864 |
1,797 |
$154K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,834 |
3,608 |
$147K |
| 99215 |
Prolong outpt/office vis |
620 |
597 |
$107K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,129 |
1,086 |
$93K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,999 |
3,839 |
$93K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,184 |
1,106 |
$87K |
| D0330 |
Panoramic radiographic image |
842 |
782 |
$74K |
| 76801 |
|
207 |
171 |
$55K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
394 |
322 |
$43K |
| H1000 |
Prenatal care, at-risk assessment |
398 |
324 |
$41K |
| 81025 |
|
4,480 |
4,294 |
$41K |
| D0274 |
Bitewings - four radiographic images |
790 |
734 |
$40K |
| D7140 |
Extraction, erupted tooth or exposed root |
323 |
123 |
$37K |
| 81003 |
|
6,668 |
5,535 |
$32K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
295 |
289 |
$29K |
| H0049 |
Alcohol and/or drug screening |
1,884 |
1,778 |
$26K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,156 |
340 |
$22K |
| 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 |
725 |
696 |
$22K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
391 |
381 |
$20K |
| D0210 |
Intraoral - complete series of radiographic images |
224 |
200 |
$16K |
| D0220 |
Intraoral - periapical first radiographic image |
610 |
565 |
$14K |
| D4355 |
|
85 |
76 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
96 |
91 |
$10K |
| 99173 |
|
1,255 |
1,188 |
$10K |
| 20610 |
|
112 |
86 |
$10K |
| 90697 |
|
373 |
315 |
$9K |
| D1206 |
Topical application of fluoride varnish |
526 |
492 |
$8K |
| 90677 |
|
255 |
227 |
$8K |
| 98940 |
|
307 |
269 |
$6K |
| 96161 |
|
810 |
698 |
$4K |
| D1110 |
Prophylaxis - adult |
32 |
29 |
$2K |
| 87210 |
|
263 |
258 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
42 |
40 |
$2K |
| 90698 |
|
125 |
125 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
22 |
21 |
$2K |
| 99451 |
|
108 |
105 |
$2K |
| 80053 |
Comprehensive metabolic panel |
26 |
26 |
$2K |
| 99381 |
|
12 |
12 |
$1K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
17 |
15 |
$1K |
| 90670 |
|
435 |
427 |
$938.78 |
| 84443 |
Thyroid stimulating hormone (TSH) |
13 |
13 |
$936.65 |
| 90651 |
|
369 |
365 |
$841.24 |
| 86803 |
|
14 |
12 |
$832.10 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
14 |
14 |
$581.46 |
| 90686 |
|
205 |
202 |
$472.45 |
| 90710 |
|
51 |
50 |
$471.08 |
| 82947 |
|
70 |
68 |
$452.56 |
| 85027 |
|
13 |
13 |
$439.92 |
| 90633 |
|
168 |
166 |
$434.22 |
| 90619 |
|
46 |
46 |
$370.80 |
| 87340 |
|
13 |
12 |
$349.90 |
| 90681 |
|
72 |
72 |
$166.26 |
| 90734 |
|
53 |
53 |
$160.72 |
| 90744 |
|
53 |
53 |
$150.05 |
| 83986 |
|
12 |
12 |
$60.34 |
| 90648 |
|
14 |
14 |
$37.52 |
| 90656 |
|
13 |
13 |
$0.13 |
| D1310 |
|
125 |
107 |
$0.00 |