| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
127,136 |
113,997 |
$3.84M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28,574 |
27,341 |
$2.39M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27,884 |
27,299 |
$2.29M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
49,804 |
43,785 |
$1.88M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16,053 |
15,651 |
$1.20M |
| H1000 |
Prenatal care, at-risk assessment |
27,188 |
19,580 |
$1.11M |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
8,620 |
8,458 |
$663K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
67,314 |
65,098 |
$307K |
| 90834 |
Psychotherapy, 45 minutes with patient |
5,520 |
3,611 |
$302K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
9,376 |
8,849 |
$267K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
42,676 |
41,354 |
$265K |
| 59410 |
|
212 |
197 |
$194K |
| D0120 |
Periodic oral evaluation - established patient |
2,616 |
2,609 |
$108K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,114 |
1,038 |
$92K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,193 |
1,516 |
$87K |
| 90791 |
Psychiatric diagnostic evaluation |
937 |
802 |
$78K |
| D1120 |
Prophylaxis - child |
2,384 |
2,376 |
$78K |
| 99381 |
|
1,016 |
990 |
$72K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
67 |
61 |
$56K |
| 59430 |
|
1,364 |
1,185 |
$51K |
| D1110 |
Prophylaxis - adult |
802 |
797 |
$40K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
620 |
443 |
$37K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
523 |
522 |
$29K |
| 85018 |
|
38,288 |
37,070 |
$25K |
| 59025 |
Fetal non-stress test |
497 |
288 |
$23K |
| 90474 |
|
7,170 |
7,018 |
$22K |
| 81025 |
|
9,626 |
8,553 |
$21K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
377 |
273 |
$18K |
| 99188 |
|
2,688 |
2,631 |
$16K |
| 81002 |
|
27,606 |
21,099 |
$16K |
| D1351 |
Sealant - per tooth |
776 |
230 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
499 |
464 |
$13K |
| D0140 |
Limited oral evaluation - problem focused |
480 |
476 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,273 |
2,921 |
$11K |
| 90633 |
|
7,809 |
7,617 |
$9K |
| 90686 |
|
11,153 |
10,780 |
$9K |
| D0330 |
Panoramic radiographic image |
274 |
274 |
$8K |
| 99215 |
Prolong outpt/office vis |
109 |
104 |
$6K |
| D0274 |
Bitewings - four radiographic images |
597 |
597 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
149 |
143 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
4,137 |
4,082 |
$5K |
| 90670 |
|
15,902 |
15,470 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,682 |
1,581 |
$4K |
| D1999 |
|
74 |
74 |
$4K |
| 3008F |
|
166,798 |
140,490 |
$4K |
| H0049 |
Alcohol and/or drug screening |
868 |
776 |
$4K |
| 3074F |
|
9,577 |
8,308 |
$4K |
| D7140 |
Extraction, erupted tooth or exposed root |
100 |
57 |
$4K |
| 90681 |
|
5,577 |
5,450 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
69 |
68 |
$3K |
| 0072A |
|
92 |
66 |
$2K |
| 90674 |
|
812 |
775 |
$2K |
| 0071A |
|
81 |
65 |
$2K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
114 |
101 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
40 |
28 |
$2K |
| 90648 |
|
5,590 |
5,461 |
$2K |
| D1206 |
Topical application of fluoride varnish |
4,136 |
4,113 |
$1K |
| 99403 |
|
52 |
41 |
$1K |
| 90723 |
|
3,321 |
3,252 |
$1K |
| 90651 |
|
2,583 |
2,498 |
$1K |
| 99383 |
|
14 |
14 |
$988.82 |
| 90685 |
|
1,102 |
1,081 |
$955.04 |
| D1330 |
|
4,110 |
4,086 |
$869.79 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$790.67 |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,235 |
3,181 |
$681.72 |
| 99201 |
|
13 |
13 |
$537.14 |
| 90698 |
|
2,101 |
2,062 |
$523.00 |
| 82962 |
|
755 |
673 |
$491.04 |
| 90700 |
|
689 |
676 |
$425.31 |
| 36415 |
Collection of venous blood by venipuncture |
175 |
172 |
$413.00 |
| 3075F |
|
1,276 |
1,110 |
$350.00 |
| 87428 |
|
13 |
13 |
$321.39 |
| D0272 |
Bitewings - two radiographic images |
2,005 |
1,999 |
$318.11 |
| 90696 |
|
215 |
213 |
$308.00 |
| 93000 |
|
45 |
35 |
$279.64 |
| 17250 |
|
12 |
12 |
$253.00 |
| 90710 |
|
456 |
443 |
$246.10 |
| 90734 |
|
1,073 |
1,060 |
$242.00 |
| 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 |
16 |
12 |
$207.28 |
| 90697 |
|
3,653 |
3,480 |
$190.53 |
| 0011A |
|
13 |
12 |
$189.74 |
| 90707 |
|
792 |
780 |
$173.38 |
| 3015F |
|
14,102 |
11,282 |
$169.75 |
| 96380 |
|
27 |
27 |
$160.00 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
16 |
14 |
$154.33 |
| 90715 |
|
381 |
359 |
$118.11 |
| 3078F |
|
7,328 |
5,935 |
$97.56 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
32 |
29 |
$92.00 |
| 90744 |
|
751 |
737 |
$90.00 |
| D9999 |
Unspecified adjunctive procedure, by report |
72 |
72 |
$80.00 |
| 90716 |
|
870 |
856 |
$75.88 |
| 87210 |
|
40 |
31 |
$47.51 |
| 3079F |
|
7,128 |
5,762 |
$42.74 |
| 3077F |
|
2,760 |
2,242 |
$39.22 |
| 92015 |
Determination of refractive state |
960 |
890 |
$27.31 |
| 92250 |
|
842 |
779 |
$27.31 |
| 36416 |
|
8,827 |
7,776 |
$22.62 |
| 90656 |
|
28 |
28 |
$20.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
53 |
42 |
$1.65 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
87 |
67 |
$0.01 |
| 1160F |
|
199 |
183 |
$0.00 |
| D0270 |
|
13 |
13 |
$0.00 |
| 1159F |
|
219 |
199 |
$0.00 |
| V2025 |
Deluxe frame |
53 |
53 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
66 |
55 |
$0.00 |
| 91300 |
|
12 |
12 |
$0.00 |
| 90677 |
|
2,624 |
2,596 |
$0.00 |
| 1111F |
|
1,826 |
1,448 |
$0.00 |
| 3080F |
|
373 |
267 |
$0.00 |
| 4010F |
|
2,065 |
1,631 |
$0.00 |
| 3014F |
|
864 |
706 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
345 |
332 |
$0.00 |
| 3044F |
|
77 |
65 |
$0.00 |
| 3060F |
|
40 |
40 |
$0.00 |
| 91307 |
|
380 |
213 |
$0.00 |
| 1126F |
|
25 |
24 |
$0.00 |
| 3049F |
|
39 |
39 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
13 |
13 |
$0.00 |
| 90619 |
|
182 |
173 |
$0.00 |
| 94760 |
|
64 |
51 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
38 |
38 |
$0.00 |
| 3048F |
|
89 |
78 |
$0.00 |
| 90381 |
|
13 |
13 |
$0.00 |
| 90620 |
|
53 |
50 |
$0.00 |
| 3061F |
|
21 |
15 |
$0.00 |