| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
113,589 |
73,179 |
$11.53M |
| D1110 |
Prophylaxis - adult |
14,146 |
10,753 |
$1.63M |
| D0120 |
Periodic oral evaluation - established patient |
8,724 |
6,887 |
$422K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,312 |
3,314 |
$272K |
| D1120 |
Prophylaxis - child |
3,153 |
2,902 |
$119K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,975 |
2,954 |
$117K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,813 |
4,718 |
$114K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,366 |
2,332 |
$88K |
| 92551 |
|
11,776 |
11,759 |
$80K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,381 |
2,364 |
$77K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,557 |
1,213 |
$77K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,632 |
6,574 |
$75K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,306 |
1,246 |
$63K |
| D1351 |
Sealant - per tooth |
791 |
313 |
$56K |
| D0274 |
Bitewings - four radiographic images |
4,536 |
4,533 |
$54K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,459 |
1,455 |
$50K |
| D0140 |
Limited oral evaluation - problem focused |
756 |
565 |
$48K |
| 90837 |
Psychotherapy, 53 minutes with patient |
396 |
211 |
$48K |
| D0220 |
Intraoral - periapical first radiographic image |
4,795 |
4,672 |
$42K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,153 |
1,143 |
$37K |
| D0230 |
Intraoral - periapical each additional radiographic image |
8,460 |
5,802 |
$37K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,093 |
2,087 |
$36K |
| 97802 |
|
1,125 |
1,103 |
$33K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
578 |
549 |
$30K |
| D0210 |
Intraoral - complete series of radiographic images |
999 |
996 |
$23K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
251 |
166 |
$23K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,622 |
2,614 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
505 |
489 |
$20K |
| 97803 |
|
796 |
720 |
$20K |
| 90686 |
|
4,526 |
4,502 |
$17K |
| 99442 |
|
926 |
819 |
$16K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,956 |
3,952 |
$15K |
| 99173 |
|
9,596 |
9,574 |
$9K |
| 99385 |
|
112 |
112 |
$9K |
| 92587 |
|
2,531 |
2,530 |
$8K |
| 81025 |
|
1,475 |
1,450 |
$8K |
| 99441 |
|
714 |
624 |
$7K |
| 81002 |
|
2,482 |
1,874 |
$6K |
| D9430 |
|
49 |
39 |
$4K |
| 86580 |
|
411 |
408 |
$3K |
| D0272 |
Bitewings - two radiographic images |
396 |
394 |
$3K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
893 |
889 |
$3K |
| 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 |
23 |
12 |
$2K |
| 0012A |
|
94 |
94 |
$767.96 |
| 0011A |
|
83 |
83 |
$710.05 |
| 90677 |
|
52 |
52 |
$692.79 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
290 |
289 |
$686.49 |
| 90656 |
|
152 |
152 |
$669.18 |
| D1999 |
|
12 |
12 |
$600.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
16 |
13 |
$551.20 |
| 0064A |
|
45 |
45 |
$437.21 |
| 99401 |
|
68 |
67 |
$431.70 |
| D0270 |
|
53 |
53 |
$303.37 |
| D9995 |
|
19 |
19 |
$211.32 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
822 |
818 |
$208.19 |
| 93000 |
|
14 |
14 |
$163.65 |
| D0603 |
|
2,357 |
2,356 |
$119.00 |
| 90687 |
|
16 |
16 |
$102.42 |
| D0602 |
|
1,095 |
1,095 |
$83.00 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
14 |
12 |
$55.55 |
| 82948 |
|
64 |
62 |
$44.21 |
| 90670 |
|
701 |
701 |
$0.00 |
| 80061 |
Lipid panel |
6,932 |
6,884 |
$0.00 |
| 86480 |
|
2,125 |
2,124 |
$0.00 |
| 90685 |
|
104 |
104 |
$0.00 |
| 83655 |
|
1,261 |
1,254 |
$0.00 |
| 90661 |
|
155 |
155 |
$0.00 |
| 90710 |
|
24 |
24 |
$0.00 |
| 90734 |
|
428 |
428 |
$0.00 |
| 90633 |
|
190 |
190 |
$0.00 |
| 90715 |
|
97 |
97 |
$0.00 |
| 96160 |
|
32 |
32 |
$0.00 |
| 90649 |
|
122 |
122 |
$0.00 |
| 84156 |
|
52 |
52 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
8,801 |
8,752 |
$0.00 |
| 99429 |
|
6,609 |
6,515 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,808 |
5,779 |
$0.00 |
| 81005 |
|
2,457 |
2,431 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
632 |
632 |
$0.00 |
| 87110 |
|
2,706 |
2,685 |
$0.00 |
| 90698 |
|
275 |
275 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
1,395 |
1,389 |
$0.00 |
| D1330 |
|
765 |
765 |
$0.00 |
| 90688 |
|
164 |
163 |
$0.00 |
| 86706 |
|
246 |
246 |
$0.00 |
| D0601 |
|
88 |
88 |
$0.00 |
| 90650 |
|
314 |
312 |
$0.00 |
| 82043 |
|
52 |
52 |
$0.00 |
| 85027 |
|
197 |
196 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
28 |
28 |
$0.00 |
| 96161 |
|
137 |
137 |
$0.00 |
| 91301 |
|
117 |
114 |
$0.00 |
| 90744 |
|
41 |
41 |
$0.00 |
| 91306 |
|
31 |
31 |
$0.00 |
| 96127 |
|
32 |
32 |
$0.00 |
| 90620 |
|
69 |
69 |
$0.00 |
| 86803 |
|
131 |
131 |
$0.00 |
| 94760 |
|
37 |
35 |
$0.00 |
| 90619 |
|
30 |
30 |
$0.00 |
| 90674 |
|
99 |
99 |
$0.00 |