| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,596 |
5,829 |
$581K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,582 |
3,220 |
$563K |
| 99215 |
Prolong outpt/office vis |
314 |
266 |
$70K |
| 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 |
2,376 |
2,167 |
$67K |
| 11056 |
|
907 |
743 |
$66K |
| D7140 |
Extraction, erupted tooth or exposed root |
460 |
246 |
$50K |
| 90834 |
Psychotherapy, 45 minutes with patient |
247 |
169 |
$34K |
| 11721 |
|
4,193 |
3,418 |
$29K |
| D0220 |
Intraoral - periapical first radiographic image |
717 |
622 |
$20K |
| 99408 |
|
147 |
137 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
191 |
171 |
$12K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
127 |
120 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
113 |
105 |
$8K |
| 81025 |
|
619 |
569 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
88 |
80 |
$7K |
| D0272 |
Bitewings - two radiographic images |
152 |
135 |
$6K |
| D0230 |
Intraoral - periapical each additional radiographic image |
269 |
171 |
$6K |
| 90832 |
Psychotherapy, 30 minutes with patient |
50 |
38 |
$6K |
| D0330 |
Panoramic radiographic image |
54 |
49 |
$5K |
| 11055 |
|
83 |
62 |
$5K |
| 0071A |
|
147 |
127 |
$4K |
| 0001A |
|
157 |
139 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
72 |
70 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
19 |
17 |
$4K |
| D1110 |
Prophylaxis - adult |
45 |
41 |
$2K |
| 0064A |
|
71 |
61 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
28 |
$2K |
| 0002A |
|
75 |
57 |
$2K |
| 0012A |
|
56 |
55 |
$2K |
| 0072A |
|
70 |
51 |
$2K |
| 0011A |
|
67 |
57 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
18 |
18 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
113 |
104 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
13 |
12 |
$1K |
| 81003 |
|
170 |
127 |
$758.32 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
14 |
$435.80 |
| 99442 |
|
138 |
110 |
$307.07 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
13 |
13 |
$270.85 |
| 99406 |
|
17 |
15 |
$150.78 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
50 |
43 |
$134.79 |
| 96127 |
|
59 |
51 |
$18.33 |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
12 |
12 |
$7.28 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$2.57 |
| 1000F |
|
15 |
14 |
$0.00 |
| 91307 |
|
81 |
64 |
$0.00 |
| 1126F |
|
15 |
15 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
14 |
14 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
116 |
71 |
$0.00 |