| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
95,981 |
53,065 |
$8.08M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,517 |
5,483 |
$956K |
| 90834 |
Psychotherapy, 45 minutes with patient |
6,587 |
2,531 |
$884K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,923 |
3,627 |
$608K |
| D1110 |
Prophylaxis - adult |
10,357 |
3,595 |
$509K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
8,900 |
2,258 |
$373K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
10,071 |
2,315 |
$370K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,400 |
2,268 |
$335K |
| 99442 |
|
2,995 |
2,016 |
$326K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,044 |
996 |
$302K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
8,663 |
1,823 |
$280K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
7,089 |
1,382 |
$218K |
| D0140 |
Limited oral evaluation - problem focused |
2,766 |
1,227 |
$184K |
| 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 |
1,677 |
1,675 |
$172K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,250 |
639 |
$134K |
| D0120 |
Periodic oral evaluation - established patient |
4,117 |
2,055 |
$115K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,306 |
720 |
$108K |
| 99443 |
|
927 |
614 |
$106K |
| 82948 |
|
3,274 |
2,142 |
$77K |
| 2022F |
|
1,432 |
678 |
$72K |
| 92551 |
|
5,814 |
4,002 |
$68K |
| 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 |
973 |
492 |
$60K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,886 |
1,131 |
$57K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,588 |
1,716 |
$50K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
580 |
269 |
$49K |
| 92015 |
Determination of refractive state |
3,052 |
2,686 |
$46K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
419 |
188 |
$40K |
| D0210 |
Intraoral - complete series of radiographic images |
652 |
374 |
$29K |
| 99441 |
|
213 |
153 |
$25K |
| D0220 |
Intraoral - periapical first radiographic image |
2,598 |
2,533 |
$24K |
| D0274 |
Bitewings - four radiographic images |
1,141 |
1,068 |
$24K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
222 |
122 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
942 |
933 |
$22K |
| V2020 |
Frames, purchases |
1,052 |
1,040 |
$21K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,856 |
4,809 |
$21K |
| 36415 |
Collection of venous blood by venipuncture |
2,382 |
1,990 |
$20K |
| D1120 |
Prophylaxis - child |
495 |
151 |
$19K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
227 |
120 |
$17K |
| 90686 |
|
3,375 |
3,280 |
$17K |
| 99173 |
|
3,945 |
3,435 |
$16K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
364 |
126 |
$14K |
| 97802 |
|
3,515 |
3,476 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,722 |
1,689 |
$13K |
| D1206 |
Topical application of fluoride varnish |
414 |
141 |
$12K |
| 2023F |
|
459 |
386 |
$9K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
329 |
317 |
$7K |
| 99386 |
|
49 |
26 |
$6K |
| 90461 |
|
2,371 |
2,361 |
$5K |
| 0011A |
|
269 |
269 |
$5K |
| 0013A |
|
146 |
146 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
61 |
15 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
157 |
156 |
$4K |
| 0012A |
|
127 |
127 |
$4K |
| 81025 |
|
446 |
423 |
$3K |
| 99384 |
|
65 |
12 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
31 |
13 |
$3K |
| 3008F |
|
306 |
250 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
507 |
499 |
$3K |
| D0602 |
|
104 |
31 |
$3K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
24 |
12 |
$3K |
| 81003 |
|
241 |
212 |
$2K |
| 90658 |
|
673 |
673 |
$2K |
| 90697 |
|
25 |
25 |
$2K |
| 90677 |
|
161 |
156 |
$2K |
| 99385 |
|
16 |
12 |
$1K |
| 96167 |
|
18 |
16 |
$1K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
24 |
24 |
$1K |
| 92002 |
|
15 |
12 |
$969.10 |
| 99383 |
|
14 |
14 |
$875.91 |
| 90633 |
|
405 |
382 |
$784.04 |
| D1208 |
Topical application of fluoride, excluding varnish |
42 |
42 |
$459.21 |
| 90670 |
|
774 |
772 |
$330.00 |
| D0270 |
|
17 |
13 |
$289.31 |
| 0003A |
|
13 |
13 |
$286.50 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
16 |
$229.19 |
| D1330 |
|
119 |
116 |
$167.42 |
| 87430 |
|
51 |
51 |
$158.04 |
| 90655 |
|
135 |
135 |
$155.17 |
| 90651 |
|
112 |
112 |
$150.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
42 |
42 |
$122.21 |
| 90662 |
|
16 |
16 |
$120.00 |
| 90648 |
|
244 |
243 |
$75.00 |
| 91301 |
|
481 |
474 |
$0.03 |
| 91300 |
|
47 |
46 |
$0.02 |
| 90715 |
|
30 |
30 |
$0.01 |
| 90681 |
|
38 |
38 |
$0.00 |
| 90710 |
|
81 |
80 |
$0.00 |
| 90734 |
|
59 |
59 |
$0.00 |
| 90713 |
|
20 |
17 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| 99174 |
|
26 |
26 |
$0.00 |
| 90680 |
|
50 |
50 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |
| 90723 |
|
25 |
25 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |