| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,316 |
2,075 |
$68K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,167 |
1,033 |
$49K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,035 |
871 |
$37K |
| D0120 |
Periodic oral evaluation - established patient |
1,761 |
1,397 |
$19K |
| 80305 |
|
1,884 |
1,018 |
$19K |
| D1110 |
Prophylaxis - adult |
595 |
562 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
406 |
376 |
$11K |
| D1206 |
Topical application of fluoride varnish |
1,041 |
861 |
$11K |
| 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 |
398 |
308 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
875 |
732 |
$9K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
1,069 |
379 |
$8K |
| D1120 |
Prophylaxis - child |
455 |
374 |
$7K |
| 92015 |
Determination of refractive state |
1,111 |
945 |
$7K |
| 99000 |
|
2,048 |
1,591 |
$6K |
| D0274 |
Bitewings - four radiographic images |
226 |
215 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
54 |
53 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
52 |
37 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
75 |
69 |
$1K |
| 99215 |
Prolong outpt/office vis |
16 |
13 |
$1K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
51 |
47 |
$1K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
40 |
38 |
$1K |
| D1351 |
Sealant - per tooth |
69 |
12 |
$1K |
| 3008F |
|
95 |
80 |
$730.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
40 |
38 |
$649.01 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
12 |
$632.83 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
29 |
25 |
$597.80 |
| 80053 |
Comprehensive metabolic panel |
97 |
79 |
$587.92 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
31 |
12 |
$564.85 |
| D1354 |
|
41 |
16 |
$352.44 |
| 98940 |
|
39 |
14 |
$325.12 |
| 96127 |
|
70 |
52 |
$174.61 |
| 80061 |
Lipid panel |
19 |
16 |
$141.20 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
37 |
28 |
$129.50 |
| D0220 |
Intraoral - periapical first radiographic image |
23 |
12 |
$93.23 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
20 |
14 |
$77.86 |
| 90686 |
|
20 |
19 |
$49.72 |
| 36415 |
Collection of venous blood by venipuncture |
648 |
518 |
$34.52 |
| V2020 |
Frames, purchases |
15 |
12 |
$4.44 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
28 |
$0.00 |