| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
34,714 |
28,179 |
$15.23M |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,479 |
1,124 |
$721K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
363 |
355 |
$159K |
| D1206 |
Topical application of fluoride varnish |
223 |
222 |
$153K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,380 |
1,242 |
$129K |
| D0140 |
Limited oral evaluation - problem focused |
147 |
141 |
$95K |
| D1110 |
Prophylaxis - adult |
18 |
18 |
$10K |
| D1120 |
Prophylaxis - child |
17 |
17 |
$10K |
| 4270 |
|
245 |
214 |
$9K |
| Q3014 |
Telehealth originating site facility fee |
254 |
187 |
$8K |
| 42700 |
|
15 |
15 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
397 |
358 |
$5K |
| 0012A |
|
252 |
189 |
$4K |
| 0011A |
|
231 |
189 |
$4K |
| 99215 |
Prolong outpt/office vis |
33 |
25 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
32 |
32 |
$3K |
| 0002A |
|
118 |
70 |
$3K |
| 0031A |
|
125 |
69 |
$2K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
634 |
573 |
$2K |
| 0001A |
|
102 |
65 |
$2K |
| 80076 |
|
380 |
359 |
$2K |
| 0064A |
|
29 |
29 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
318 |
301 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
409 |
374 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
1,101 |
969 |
$1K |
| H0016 |
Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) |
17 |
12 |
$1K |
| 80061 |
Lipid panel |
123 |
115 |
$1K |
| 91320 |
|
18 |
18 |
$1K |
| 0004A |
|
12 |
12 |
$630.52 |
| 90688 |
|
241 |
209 |
$571.62 |
| 84443 |
Thyroid stimulating hormone (TSH) |
41 |
39 |
$502.84 |
| 0124A |
|
16 |
12 |
$413.15 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
13 |
13 |
$391.12 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
16 |
16 |
$384.80 |
| 90686 |
|
20 |
20 |
$265.59 |
| 0134A |
|
13 |
13 |
$247.89 |
| A0080 |
Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest |
17 |
13 |
$201.84 |
| 81003 |
|
76 |
66 |
$92.57 |
| 91300 |
|
195 |
101 |
$0.00 |
| 91301 |
|
416 |
332 |
$0.00 |
| 91303 |
|
117 |
63 |
$0.00 |
| 90694 |
|
13 |
13 |
$0.00 |