| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21,350 |
19,066 |
$1.07M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19,577 |
17,346 |
$688K |
| D1120 |
Prophylaxis - child |
7,689 |
7,198 |
$317K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
10,640 |
9,822 |
$261K |
| D1351 |
Sealant - per tooth |
14,675 |
3,948 |
$186K |
| 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 |
14,257 |
4,795 |
$151K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,647 |
2,298 |
$114K |
| D1206 |
Topical application of fluoride varnish |
8,620 |
8,043 |
$107K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,202 |
1,021 |
$62K |
| D0140 |
Limited oral evaluation - problem focused |
1,175 |
1,080 |
$45K |
| D7140 |
Extraction, erupted tooth or exposed root |
686 |
306 |
$22K |
| D0272 |
Bitewings - two radiographic images |
931 |
916 |
$19K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,137 |
1,016 |
$16K |
| 36415 |
Collection of venous blood by venipuncture |
3,662 |
3,341 |
$15K |
| D1110 |
Prophylaxis - adult |
304 |
264 |
$14K |
| 90791 |
Psychiatric diagnostic evaluation |
179 |
169 |
$14K |
| 96127 |
|
3,359 |
3,084 |
$12K |
| D0220 |
Intraoral - periapical first radiographic image |
1,238 |
1,125 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
773 |
736 |
$11K |
| 90837 |
Psychotherapy, 53 minutes with patient |
135 |
114 |
$10K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
94 |
91 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
694 |
631 |
$8K |
| 90686 |
|
543 |
508 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
513 |
488 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
123 |
121 |
$7K |
| D2140 |
|
183 |
113 |
$6K |
| 87631 |
|
54 |
48 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
422 |
401 |
$6K |
| D0330 |
Panoramic radiographic image |
121 |
119 |
$4K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
59 |
40 |
$4K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
89 |
72 |
$4K |
| 99406 |
|
450 |
412 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
439 |
396 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
104 |
96 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
36 |
29 |
$3K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
206 |
192 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
36 |
34 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
224 |
201 |
$2K |
| 90461 |
|
196 |
146 |
$2K |
| D0274 |
Bitewings - four radiographic images |
75 |
71 |
$2K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
33 |
17 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
26 |
26 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$1K |
| 99442 |
|
17 |
16 |
$986.44 |
| 99443 |
|
12 |
12 |
$732.24 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
16 |
14 |
$585.68 |
| 36416 |
|
264 |
252 |
$470.12 |
| D1354 |
|
25 |
17 |
$300.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
51 |
27 |
$188.10 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
43 |
38 |
$157.92 |
| 99002 |
|
492 |
479 |
$149.40 |
| 90633 |
|
169 |
154 |
$138.51 |
| 81002 |
|
182 |
178 |
$87.75 |
| 81003 |
|
208 |
201 |
$84.35 |
| D9996 |
|
76 |
75 |
$0.72 |
| 90670 |
|
38 |
13 |
$0.00 |
| D0603 |
|
1,679 |
1,624 |
$0.00 |
| 90698 |
|
37 |
12 |
$0.00 |