| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,311 |
9,262 |
$1.99M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,958 |
7,078 |
$1.52M |
| D0999 |
Unspecified diagnostic procedure, by report |
2,137 |
1,441 |
$678K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
283 |
262 |
$52K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
179 |
169 |
$36K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
760 |
729 |
$35K |
| 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 |
1,815 |
1,627 |
$33K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
129 |
123 |
$30K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
119 |
117 |
$25K |
| 99215 |
Prolong outpt/office vis |
88 |
83 |
$17K |
| D1110 |
Prophylaxis - adult |
363 |
265 |
$10K |
| D7140 |
Extraction, erupted tooth or exposed root |
240 |
90 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
234 |
211 |
$7K |
| D1206 |
Topical application of fluoride varnish |
317 |
231 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
157 |
118 |
$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 |
241 |
197 |
$3K |
| 99382 |
|
13 |
13 |
$3K |
| 99383 |
|
12 |
12 |
$3K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
817 |
775 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
311 |
275 |
$1K |
| 99000 |
|
147 |
124 |
$765.75 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
950 |
885 |
$625.90 |
| D0210 |
Intraoral - complete series of radiographic images |
14 |
13 |
$483.00 |
| D0120 |
Periodic oral evaluation - established patient |
79 |
71 |
$445.00 |
| D0274 |
Bitewings - four radiographic images |
47 |
42 |
$382.00 |
| 99173 |
|
72 |
72 |
$228.87 |
| D0140 |
Limited oral evaluation - problem focused |
162 |
161 |
$201.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
30 |
30 |
$50.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
137 |
128 |
$0.00 |
| 90686 |
|
373 |
364 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
19 |
19 |
$0.00 |
| 81002 |
|
201 |
188 |
$0.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
48 |
48 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
41 |
38 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
98 |
96 |
$0.00 |
| 81025 |
|
42 |
14 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
29 |
27 |
$0.00 |
| D0330 |
Panoramic radiographic image |
13 |
13 |
$0.00 |