| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
82,701 |
71,483 |
$11.70M |
| D0999 |
Unspecified diagnostic procedure, by report |
21,316 |
19,875 |
$5.18M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16,873 |
15,514 |
$2.13M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,029 |
7,362 |
$767K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,399 |
4,367 |
$668K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
3,765 |
2,526 |
$631K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,133 |
4,101 |
$547K |
| H0031 |
Mental health assessment, by non-physician |
3,175 |
1,706 |
$540K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,550 |
2,517 |
$448K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,870 |
2,824 |
$343K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
17,261 |
17,061 |
$324K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,336 |
793 |
$194K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
825 |
765 |
$148K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
648 |
634 |
$118K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
620 |
604 |
$96K |
| 90686 |
|
4,039 |
3,989 |
$86K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
273 |
266 |
$45K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
256 |
254 |
$40K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,912 |
5,779 |
$36K |
| D0145 |
Oral evaluation for a patient under three years of age |
1,488 |
1,452 |
$33K |
| D7140 |
Extraction, erupted tooth or exposed root |
338 |
177 |
$31K |
| D0120 |
Periodic oral evaluation - established patient |
2,065 |
2,007 |
$30K |
| 90461 |
|
2,796 |
2,782 |
$30K |
| 90791 |
Psychiatric diagnostic evaluation |
176 |
126 |
$27K |
| D1110 |
Prophylaxis - adult |
963 |
932 |
$25K |
| 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 |
967 |
809 |
$25K |
| D0274 |
Bitewings - four radiographic images |
1,080 |
1,045 |
$22K |
| D4910 |
|
354 |
333 |
$20K |
| D0190 |
|
1,662 |
1,606 |
$18K |
| D0140 |
Limited oral evaluation - problem focused |
409 |
401 |
$16K |
| H0023 |
Behavioral health outreach service (planned approach to reach a targeted population) |
109 |
55 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
413 |
409 |
$12K |
| 99215 |
Prolong outpt/office vis |
159 |
154 |
$12K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
109 |
77 |
$11K |
| 0011A |
|
288 |
288 |
$11K |
| D0220 |
Intraoral - periapical first radiographic image |
1,203 |
1,191 |
$9K |
| D1120 |
Prophylaxis - child |
514 |
508 |
$7K |
| 99385 |
|
34 |
34 |
$7K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
91 |
67 |
$6K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
341 |
283 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
25 |
25 |
$6K |
| D0330 |
Panoramic radiographic image |
95 |
95 |
$4K |
| D1206 |
Topical application of fluoride varnish |
10,071 |
9,747 |
$4K |
| 99401 |
|
452 |
433 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
590 |
536 |
$3K |
| 90670 |
|
37 |
37 |
$3K |
| 90672 |
|
14 |
14 |
$2K |
| 90480 |
|
51 |
50 |
$2K |
| 0012A |
|
47 |
47 |
$2K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
5,847 |
5,117 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
2,775 |
2,691 |
$1K |
| D0180 |
|
27 |
27 |
$870.00 |
| 92551 |
|
5,487 |
5,431 |
$651.66 |
| D1351 |
Sealant - per tooth |
40 |
13 |
$544.00 |
| 0064A |
|
13 |
13 |
$520.00 |
| 0134A |
|
13 |
12 |
$480.00 |
| 99000 |
|
659 |
638 |
$454.11 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
26 |
19 |
$400.86 |
| 36416 |
|
1,852 |
1,770 |
$387.10 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
86 |
85 |
$204.24 |
| 90698 |
|
14 |
14 |
$200.43 |
| 90682 |
|
15 |
15 |
$200.43 |
| 99173 |
|
4,541 |
4,495 |
$193.55 |
| 90732 |
|
15 |
15 |
$191.55 |
| D0230 |
Intraoral - periapical each additional radiographic image |
73 |
73 |
$126.00 |
| 82948 |
|
195 |
183 |
$8.16 |
| 85018 |
|
1,381 |
1,348 |
$4.10 |
| 90673 |
|
24 |
24 |
$0.00 |
| D9995 |
|
32 |
32 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
110 |
108 |
$0.00 |
| D4342 |
|
23 |
12 |
$0.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
15 |
12 |
$0.00 |
| 90677 |
|
13 |
13 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
38 |
37 |
$0.00 |
| 98926 |
|
13 |
13 |
$0.00 |
| 81025 |
|
420 |
394 |
$0.00 |
| 81003 |
|
1,472 |
1,274 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
36 |
34 |
$0.00 |