| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,025 |
8,931 |
$451K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,112 |
4,751 |
$369K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,638 |
641 |
$62K |
| D0140 |
Limited oral evaluation - problem focused |
2,135 |
1,508 |
$31K |
| 90834 |
Psychotherapy, 45 minutes with patient |
406 |
270 |
$17K |
| D9995 |
|
779 |
447 |
$16K |
| D0220 |
Intraoral - periapical first radiographic image |
2,275 |
1,671 |
$16K |
| 36415 |
Collection of venous blood by venipuncture |
7,003 |
6,375 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
170 |
162 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
369 |
346 |
$9K |
| 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 |
887 |
747 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
337 |
287 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
80 |
80 |
$6K |
| 90686 |
|
558 |
518 |
$6K |
| D0210 |
Intraoral - complete series of radiographic images |
82 |
73 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,047 |
1,945 |
$4K |
| D0330 |
Panoramic radiographic image |
117 |
107 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
183 |
177 |
$3K |
| D0170 |
|
195 |
113 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
221 |
193 |
$3K |
| D1110 |
Prophylaxis - adult |
73 |
73 |
$3K |
| D4341 |
|
48 |
33 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$2K |
| 90672 |
|
221 |
210 |
$2K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
37 |
32 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
243 |
213 |
$2K |
| 92551 |
|
165 |
162 |
$1K |
| 81002 |
|
455 |
439 |
$1K |
| 99442 |
|
74 |
68 |
$1K |
| 99173 |
|
462 |
450 |
$1K |
| D0274 |
Bitewings - four radiographic images |
66 |
66 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$1K |
| 90651 |
|
43 |
42 |
$857.00 |
| 90619 |
|
13 |
12 |
$784.15 |
| 90832 |
Psychotherapy, 30 minutes with patient |
17 |
12 |
$637.45 |
| 90688 |
|
39 |
39 |
$632.24 |
| 99000 |
|
370 |
346 |
$559.36 |
| 90461 |
|
397 |
379 |
$557.63 |
| 85018 |
|
247 |
244 |
$553.20 |
| 90756 |
|
33 |
31 |
$492.50 |
| 0011A |
|
29 |
29 |
$491.98 |
| 90734 |
|
13 |
12 |
$454.93 |
| 90633 |
|
28 |
27 |
$309.59 |
| D0230 |
Intraoral - periapical each additional radiographic image |
36 |
13 |
$234.78 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
37 |
34 |
$205.24 |
| 36416 |
|
408 |
376 |
$148.42 |
| 90658 |
|
17 |
13 |
$118.98 |
| 81025 |
|
12 |
12 |
$80.30 |
| 96127 |
|
14 |
14 |
$69.19 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
19 |
19 |
$66.24 |
| 90473 |
|
130 |
121 |
$45.49 |
| 82962 |
|
13 |
13 |
$29.70 |
| 90474 |
|
26 |
24 |
$20.64 |
| 91301 |
|
57 |
56 |
$0.46 |
| 91307 |
|
26 |
25 |
$0.00 |