| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45,567 |
41,511 |
$1.46M |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
13,843 |
11,139 |
$1.18M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,904 |
2,853 |
$247K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,252 |
2,212 |
$198K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,228 |
2,080 |
$191K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,242 |
3,854 |
$175K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,755 |
6,408 |
$156K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
5,013 |
4,744 |
$118K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,232 |
1,210 |
$111K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,701 |
7,221 |
$84K |
| 92552 |
|
5,384 |
5,282 |
$61K |
| D0330 |
Panoramic radiographic image |
767 |
762 |
$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 |
3,000 |
2,331 |
$36K |
| 87428 |
|
877 |
850 |
$31K |
| D1120 |
Prophylaxis - child |
834 |
834 |
$27K |
| D0120 |
Periodic oral evaluation - established patient |
1,925 |
1,924 |
$23K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,082 |
3,930 |
$22K |
| D1351 |
Sealant - per tooth |
1,673 |
496 |
$21K |
| 90671 |
|
279 |
278 |
$16K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
375 |
302 |
$16K |
| D0274 |
Bitewings - four radiographic images |
1,122 |
1,122 |
$15K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
211 |
176 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
635 |
634 |
$10K |
| D0140 |
Limited oral evaluation - problem focused |
919 |
910 |
$10K |
| D0603 |
|
522 |
522 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,532 |
1,474 |
$7K |
| D0602 |
|
481 |
481 |
$6K |
| 90461 |
|
3,819 |
3,479 |
$6K |
| D0210 |
Intraoral - complete series of radiographic images |
65 |
65 |
$5K |
| D1110 |
Prophylaxis - adult |
94 |
94 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
577 |
540 |
$4K |
| D1310 |
|
793 |
793 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
57 |
56 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
104 |
100 |
$4K |
| D1330 |
|
1,246 |
1,245 |
$3K |
| 96127 |
|
396 |
378 |
$3K |
| 90670 |
|
639 |
619 |
$3K |
| D1206 |
Topical application of fluoride varnish |
1,607 |
1,605 |
$2K |
| D0601 |
|
143 |
143 |
$2K |
| D0272 |
Bitewings - two radiographic images |
957 |
951 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
55 |
53 |
$2K |
| 99406 |
|
400 |
327 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
15 |
$2K |
| 85018 |
|
2,022 |
1,940 |
$2K |
| 99384 |
|
14 |
13 |
$1K |
| 92551 |
|
169 |
162 |
$1K |
| 99383 |
|
12 |
12 |
$1K |
| 99381 |
|
13 |
12 |
$1K |
| D7140 |
Extraction, erupted tooth or exposed root |
35 |
24 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
423 |
411 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
19 |
16 |
$911.52 |
| 87807 |
|
223 |
218 |
$850.87 |
| 3074F |
|
751 |
704 |
$650.00 |
| D1354 |
|
88 |
25 |
$572.64 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
43 |
41 |
$565.29 |
| 90686 |
|
1,626 |
1,594 |
$375.02 |
| D0999 |
Unspecified diagnostic procedure, by report |
15 |
15 |
$300.00 |
| 82962 |
|
503 |
472 |
$272.53 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
77 |
75 |
$262.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
27 |
26 |
$252.00 |
| 90651 |
|
138 |
136 |
$198.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,281 |
1,162 |
$148.35 |
| 99177 |
|
5,032 |
4,743 |
$134.64 |
| 0012A |
|
13 |
13 |
$130.60 |
| 81025 |
|
41 |
40 |
$84.48 |
| 93000 |
|
15 |
15 |
$84.39 |
| 81002 |
|
66 |
65 |
$68.60 |
| D0220 |
Intraoral - periapical first radiographic image |
352 |
348 |
$62.13 |
| 95251 |
|
26 |
24 |
$54.47 |
| 99173 |
|
479 |
431 |
$29.38 |
| 3075F |
|
14 |
12 |
$25.00 |
| 36415 |
Collection of venous blood by venipuncture |
57 |
54 |
$12.00 |
| 90647 |
|
235 |
233 |
$10.00 |
| 90723 |
|
461 |
451 |
$0.00 |
| 3079F |
|
194 |
152 |
$0.00 |
| D3120 |
|
16 |
16 |
$0.00 |
| D1320 |
|
58 |
55 |
$0.00 |
| 90656 |
|
58 |
58 |
$0.00 |
| 94760 |
|
21 |
14 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
12 |
12 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
18 |
18 |
$0.00 |
| 90648 |
|
264 |
258 |
$0.00 |
| 3078F |
|
295 |
254 |
$0.00 |
| 3077F |
|
12 |
12 |
$0.00 |
| 90681 |
|
26 |
25 |
$0.00 |
| 90633 |
|
235 |
234 |
$0.00 |
| 90734 |
|
114 |
114 |
$0.00 |
| 99497 |
|
14 |
13 |
$0.00 |