| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
907 |
641 |
$67K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
541 |
396 |
$43K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
164 |
137 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
130 |
110 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
75 |
64 |
$7K |
| 99383 |
|
50 |
48 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
82 |
77 |
$5K |
| 99384 |
|
20 |
17 |
$2K |
| D0999 |
Unspecified diagnostic procedure, by report |
14 |
13 |
$2K |
| 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 |
85 |
69 |
$1K |
| D0330 |
Panoramic radiographic image |
120 |
108 |
$881.05 |
| D0220 |
Intraoral - periapical first radiographic image |
13 |
12 |
$235.76 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
60 |
57 |
$20.79 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
51 |
33 |
$0.00 |
| 92551 |
|
239 |
216 |
$0.00 |
| 99173 |
|
261 |
229 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
48 |
36 |
$0.00 |
| 99401 |
|
18 |
12 |
$0.00 |