| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24,468 |
21,192 |
$1.11M |
| T1015 |
Clinic visit/encounter, all-inclusive |
40,790 |
34,080 |
$709K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,794 |
8,236 |
$639K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,428 |
4,206 |
$359K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,204 |
3,688 |
$317K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,230 |
3,659 |
$158K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
6,663 |
6,185 |
$131K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,497 |
1,405 |
$118K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
11,147 |
10,227 |
$110K |
| D9999 |
Unspecified adjunctive procedure, by report |
5,052 |
4,131 |
$70K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,370 |
847 |
$69K |
| D1120 |
Prophylaxis - child |
1,870 |
1,752 |
$67K |
| D1206 |
Topical application of fluoride varnish |
2,446 |
2,273 |
$53K |
| D0120 |
Periodic oral evaluation - established patient |
1,811 |
1,670 |
$41K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,268 |
734 |
$39K |
| 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 |
1,775 |
1,226 |
$38K |
| D1110 |
Prophylaxis - adult |
781 |
711 |
$36K |
| D1354 |
|
278 |
61 |
$26K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
722 |
641 |
$25K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,334 |
2,082 |
$15K |
| 90791 |
Psychiatric diagnostic evaluation |
185 |
156 |
$14K |
| 36415 |
Collection of venous blood by venipuncture |
4,489 |
3,938 |
$13K |
| D0274 |
Bitewings - four radiographic images |
368 |
324 |
$11K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
133 |
94 |
$10K |
| D0210 |
Intraoral - complete series of radiographic images |
208 |
181 |
$9K |
| 90686 |
|
3,648 |
3,355 |
$7K |
| D0140 |
Limited oral evaluation - problem focused |
206 |
192 |
$7K |
| 36416 |
|
2,251 |
2,088 |
$6K |
| 99381 |
|
207 |
190 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
61 |
55 |
$5K |
| 59425 |
|
54 |
40 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
86 |
66 |
$4K |
| 80061 |
Lipid panel |
835 |
743 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
381 |
358 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
91 |
83 |
$2K |
| D0272 |
Bitewings - two radiographic images |
66 |
64 |
$2K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
18 |
13 |
$2K |
| 80305 |
|
254 |
164 |
$1K |
| 87430 |
|
198 |
185 |
$1K |
| 85018 |
|
620 |
580 |
$1K |
| 97803 |
|
281 |
262 |
$1K |
| D0330 |
Panoramic radiographic image |
27 |
26 |
$903.28 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
133 |
129 |
$862.95 |
| D0145 |
Oral evaluation for a patient under three years of age |
25 |
25 |
$851.04 |
| 90670 |
|
2,018 |
1,865 |
$835.08 |
| D0220 |
Intraoral - periapical first radiographic image |
54 |
50 |
$571.55 |
| 90656 |
|
384 |
376 |
$216.48 |
| 90698 |
|
970 |
914 |
$186.56 |
| 81003 |
|
106 |
93 |
$156.00 |
| 90716 |
|
149 |
144 |
$117.80 |
| 90474 |
|
13 |
12 |
$105.00 |
| 90633 |
|
839 |
775 |
$78.72 |
| 88720 |
|
30 |
25 |
$39.88 |
| 90744 |
|
364 |
337 |
$23.42 |
| 90707 |
|
160 |
150 |
$0.00 |
| 90681 |
|
386 |
361 |
$0.00 |
| 90700 |
|
87 |
84 |
$0.00 |
| 90710 |
|
62 |
62 |
$0.00 |
| 90380 |
|
24 |
19 |
$0.00 |
| 90685 |
|
19 |
19 |
$0.00 |
| 90680 |
|
489 |
435 |
$0.00 |
| 90677 |
|
610 |
575 |
$0.00 |
| 90697 |
|
735 |
658 |
$0.00 |
| 90381 |
|
66 |
61 |
$0.00 |
| 90723 |
|
238 |
233 |
$0.00 |
| 99000 |
|
13 |
13 |
$0.00 |
| 90647 |
|
288 |
277 |
$0.00 |
| 90660 |
|
15 |
15 |
$0.00 |
| 90696 |
|
24 |
24 |
$0.00 |