| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24,721 |
20,634 |
$2.38M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,219 |
12,140 |
$972K |
| 90834 |
Psychotherapy, 45 minutes with patient |
8,893 |
5,717 |
$713K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,561 |
490 |
$197K |
| 90791 |
Psychiatric diagnostic evaluation |
1,768 |
1,593 |
$168K |
| 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 |
6,296 |
5,725 |
$168K |
| 99215 |
Prolong outpt/office vis |
895 |
747 |
$115K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
697 |
588 |
$110K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,599 |
1,440 |
$71K |
| D1110 |
Prophylaxis - adult |
846 |
775 |
$64K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
623 |
613 |
$52K |
| D0120 |
Periodic oral evaluation - established patient |
1,134 |
1,051 |
$47K |
| D0274 |
Bitewings - four radiographic images |
781 |
717 |
$44K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
484 |
455 |
$39K |
| 90832 |
Psychotherapy, 30 minutes with patient |
718 |
554 |
$38K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,613 |
480 |
$33K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
426 |
346 |
$29K |
| D0220 |
Intraoral - periapical first radiographic image |
1,284 |
1,077 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
307 |
299 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
288 |
269 |
$24K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
119 |
86 |
$22K |
| D0140 |
Limited oral evaluation - problem focused |
418 |
336 |
$22K |
| D0330 |
Panoramic radiographic image |
291 |
238 |
$21K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
256 |
220 |
$16K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
121 |
118 |
$13K |
| D1208 |
Topical application of fluoride, excluding varnish |
333 |
313 |
$11K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
61 |
36 |
$9K |
| 92015 |
Determination of refractive state |
484 |
393 |
$6K |
| V2020 |
Frames, purchases |
199 |
164 |
$5K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
169 |
128 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
40 |
37 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
240 |
109 |
$3K |
| 99383 |
|
13 |
12 |
$1K |
| 80305 |
|
49 |
41 |
$942.96 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
13 |
12 |
$726.08 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
139 |
81 |
$717.60 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
51 |
28 |
$327.24 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$158.64 |
| V2025 |
Deluxe frame |
14 |
14 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
148 |
26 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
14 |
12 |
$0.00 |