| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
91,827 |
50,663 |
$5.30M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,089 |
7,965 |
$946K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,209 |
873 |
$305K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,300 |
760 |
$91K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
998 |
583 |
$69K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
923 |
574 |
$66K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,412 |
3,388 |
$62K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
756 |
421 |
$54K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
695 |
443 |
$53K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
503 |
406 |
$49K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
401 |
400 |
$48K |
| D1110 |
Prophylaxis - adult |
662 |
606 |
$33K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
829 |
476 |
$28K |
| 96127 |
|
4,285 |
4,067 |
$28K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
485 |
277 |
$26K |
| 90686 |
|
1,986 |
1,865 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,092 |
2,007 |
$21K |
| D0120 |
Periodic oral evaluation - established patient |
541 |
400 |
$20K |
| 99493 |
|
243 |
174 |
$19K |
| 90832 |
Psychotherapy, 30 minutes with patient |
349 |
174 |
$16K |
| 76830 |
Ultrasound, transvaginal |
184 |
184 |
$15K |
| 90834 |
Psychotherapy, 45 minutes with patient |
235 |
110 |
$14K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
160 |
97 |
$12K |
| 99442 |
|
191 |
101 |
$9K |
| 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 |
407 |
161 |
$6K |
| 99441 |
|
123 |
70 |
$5K |
| D0330 |
Panoramic radiographic image |
165 |
108 |
$5K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
54 |
54 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
81 |
38 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
118 |
80 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
1,882 |
1,628 |
$3K |
| D0274 |
Bitewings - four radiographic images |
105 |
105 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
141 |
141 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
26 |
15 |
$2K |
| D1120 |
Prophylaxis - child |
48 |
40 |
$2K |
| 0012A |
|
71 |
71 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
29 |
12 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
142 |
117 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
28 |
12 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
140 |
140 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
12 |
$1K |
| 0011A |
|
73 |
71 |
$1K |
| 90715 |
|
50 |
50 |
$1K |
| 81002 |
|
1,390 |
1,209 |
$1K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
16 |
13 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
12 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
17 |
17 |
$810.56 |
| 99024 |
|
13 |
13 |
$754.27 |
| 99406 |
|
54 |
54 |
$598.25 |
| 81025 |
|
147 |
145 |
$314.46 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
42 |
42 |
$149.55 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
18 |
18 |
$147.84 |
| 86580 |
|
13 |
13 |
$18.50 |
| 90671 |
|
30 |
30 |
$0.00 |
| 90734 |
|
27 |
27 |
$0.00 |
| 99080 |
|
199 |
166 |
$0.00 |
| 90633 |
|
579 |
579 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| 90670 |
|
221 |
220 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 91301 |
|
139 |
139 |
$0.00 |
| 90698 |
|
114 |
114 |
$0.00 |
| D0603 |
|
23 |
23 |
$0.00 |
| 90680 |
|
29 |
29 |
$0.00 |
| D1330 |
|
39 |
39 |
$0.00 |
| 90744 |
|
29 |
29 |
$0.00 |