| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28,843 |
23,406 |
$871K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,773 |
10,042 |
$425K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
3,819 |
2,203 |
$247K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,393 |
2,864 |
$225K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,855 |
2,231 |
$186K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,177 |
1,851 |
$145K |
| H1000 |
Prenatal care, at-risk assessment |
2,509 |
1,558 |
$136K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,683 |
1,396 |
$111K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,436 |
2,005 |
$58K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,823 |
1,764 |
$51K |
| 97802 |
|
5,542 |
4,914 |
$46K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
11,114 |
9,344 |
$36K |
| D1110 |
Prophylaxis - adult |
1,364 |
1,340 |
$35K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
549 |
487 |
$33K |
| 99385 |
|
568 |
458 |
$32K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
6,440 |
5,260 |
$30K |
| 99383 |
|
291 |
247 |
$25K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
680 |
496 |
$21K |
| 99384 |
|
197 |
189 |
$19K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
404 |
347 |
$18K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
277 |
273 |
$18K |
| D1120 |
Prophylaxis - child |
599 |
581 |
$17K |
| 99382 |
|
171 |
167 |
$17K |
| D7140 |
Extraction, erupted tooth or exposed root |
623 |
407 |
$16K |
| H2000 |
Comprehensive multidisciplinary evaluation |
137 |
95 |
$15K |
| 36415 |
Collection of venous blood by venipuncture |
3,216 |
2,631 |
$13K |
| D0274 |
Bitewings - four radiographic images |
1,685 |
1,623 |
$10K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
225 |
181 |
$10K |
| D0140 |
Limited oral evaluation - problem focused |
752 |
729 |
$9K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
171 |
157 |
$9K |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,553 |
1,826 |
$8K |
| 90834 |
Psychotherapy, 45 minutes with patient |
212 |
172 |
$7K |
| 99381 |
|
99 |
89 |
$7K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
164 |
82 |
$7K |
| 90670 |
|
2,079 |
1,552 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
57 |
56 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
320 |
315 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
334 |
329 |
$3K |
| 83655 |
|
919 |
893 |
$3K |
| D1206 |
Topical application of fluoride varnish |
567 |
555 |
$3K |
| 90686 |
|
3,486 |
3,153 |
$2K |
| T1015 |
Clinic visit/encounter, all-inclusive |
46 |
36 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
75 |
67 |
$2K |
| 85018 |
|
3,115 |
2,446 |
$2K |
| D1330 |
|
1,239 |
1,214 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
878 |
428 |
$2K |
| 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 |
1,836 |
1,289 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
2,585 |
2,466 |
$1K |
| 99386 |
|
16 |
12 |
$784.43 |
| 81003 |
|
820 |
554 |
$772.20 |
| D0330 |
Panoramic radiographic image |
60 |
57 |
$750.70 |
| 59430 |
|
30 |
25 |
$663.56 |
| 81025 |
|
467 |
422 |
$622.09 |
| 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 |
79 |
63 |
$548.10 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$529.13 |
| 90461 |
|
227 |
79 |
$501.21 |
| 1000F |
|
24,139 |
16,297 |
$483.79 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
87 |
79 |
$444.48 |
| 84703 |
|
247 |
204 |
$301.15 |
| 90651 |
|
383 |
290 |
$286.01 |
| 99442 |
|
18 |
17 |
$267.04 |
| 90677 |
|
79 |
73 |
$259.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
584 |
574 |
$253.89 |
| 1159F |
|
12,447 |
8,433 |
$191.08 |
| 99441 |
|
195 |
48 |
$171.95 |
| 3008F |
|
27,998 |
20,315 |
$138.12 |
| 93000 |
|
18 |
12 |
$115.83 |
| 3044F |
|
1,809 |
1,538 |
$110.44 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
27 |
26 |
$109.12 |
| 3351F |
|
11,746 |
7,166 |
$100.88 |
| 90649 |
|
433 |
404 |
$98.76 |
| 87650 |
|
27 |
27 |
$92.40 |
| D0270 |
|
144 |
141 |
$88.03 |
| 99177 |
|
2,895 |
2,667 |
$73.62 |
| 96127 |
|
598 |
547 |
$72.00 |
| D0272 |
Bitewings - two radiographic images |
108 |
107 |
$70.55 |
| 2001F |
|
19,186 |
15,547 |
$68.88 |
| 3074F |
|
13,131 |
10,820 |
$63.11 |
| 3078F |
|
12,318 |
9,898 |
$63.05 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
13 |
13 |
$56.31 |
| 1126F |
|
5,274 |
3,469 |
$50.44 |
| 1160F |
|
12,417 |
8,414 |
$37.85 |
| 0513F |
|
1,341 |
839 |
$37.83 |
| 99406 |
|
68 |
57 |
$26.41 |
| 3077F |
|
597 |
448 |
$25.22 |
| 1101F |
|
129 |
70 |
$25.22 |
| 81002 |
|
397 |
256 |
$24.28 |
| 1170F |
|
1,424 |
601 |
$18.13 |
| 3075F |
|
372 |
272 |
$12.61 |
| 4000F |
|
2,956 |
2,552 |
$12.61 |
| 3079F |
|
2,291 |
1,762 |
$12.61 |
| 90633 |
|
1,094 |
937 |
$10.00 |
| 90734 |
|
388 |
345 |
$10.00 |
| 90655 |
|
588 |
572 |
$10.00 |
| 90474 |
|
41 |
14 |
$10.00 |
| 90647 |
|
14 |
14 |
$10.00 |
| 99188 |
|
116 |
111 |
$0.64 |
| 99173 |
|
761 |
469 |
$0.00 |
| 4004F |
|
2,232 |
1,480 |
$0.00 |
| 1158F |
|
78 |
39 |
$0.00 |
| 99408 |
|
632 |
590 |
$0.00 |
| 90648 |
|
684 |
620 |
$0.00 |
| 3015F |
|
293 |
243 |
$0.00 |
| 90707 |
|
174 |
163 |
$0.00 |
| 90710 |
|
66 |
65 |
$0.00 |
| 90681 |
|
288 |
236 |
$0.00 |
| 90715 |
|
119 |
82 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
247 |
215 |
$0.00 |
| 1033F |
|
25 |
25 |
$0.00 |
| 3210F |
|
13 |
12 |
$0.00 |
| 90700 |
|
54 |
54 |
$0.00 |
| 3288F |
|
86 |
43 |
$0.00 |
| 3725F |
|
52 |
30 |
$0.00 |
| 90620 |
|
189 |
185 |
$0.00 |
| 1220F |
|
7,881 |
6,349 |
$0.00 |
| 2000F |
|
14,196 |
11,393 |
$0.00 |
| 90674 |
|
33 |
31 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
3,044 |
2,805 |
$0.00 |
| 92551 |
|
2,195 |
2,015 |
$0.00 |
| 99174 |
|
1,097 |
648 |
$0.00 |
| 90723 |
|
320 |
287 |
$0.00 |
| 3352F |
|
35 |
34 |
$0.00 |
| 1036F |
|
956 |
637 |
$0.00 |
| 90696 |
|
47 |
47 |
$0.00 |
| 1111F |
|
363 |
281 |
$0.00 |
| 3080F |
|
97 |
69 |
$0.00 |
| 90716 |
|
133 |
132 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
130 |
98 |
$0.00 |
| 1125F |
|
188 |
101 |
$0.00 |
| 90698 |
|
37 |
36 |
$0.00 |