| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,642 |
4,625 |
$844K |
| D0140 |
Limited oral evaluation - problem focused |
2,186 |
2,045 |
$227K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
705 |
617 |
$145K |
| D0120 |
Periodic oral evaluation - established patient |
886 |
875 |
$104K |
| 90837 |
Psychotherapy, 53 minutes with patient |
357 |
180 |
$68K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
216 |
199 |
$41K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
185 |
166 |
$40K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
173 |
158 |
$36K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
359 |
349 |
$28K |
| D7140 |
Extraction, erupted tooth or exposed root |
279 |
183 |
$15K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
142 |
113 |
$14K |
| X5622 |
|
173 |
60 |
$7K |
| D5899 |
|
87 |
62 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
42 |
39 |
$5K |
| 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 |
181 |
165 |
$5K |
| 92015 |
Determination of refractive state |
741 |
670 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
16 |
15 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
674 |
628 |
$983.52 |
| 36415 |
Collection of venous blood by venipuncture |
1,298 |
1,102 |
$277.67 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
396 |
339 |
$141.52 |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,094 |
1,449 |
$96.80 |
| D0220 |
Intraoral - periapical first radiographic image |
2,238 |
2,146 |
$83.50 |
| 0011A |
|
251 |
193 |
$49.17 |
| 86703 |
|
18 |
12 |
$38.68 |
| D0274 |
Bitewings - four radiographic images |
1,077 |
1,050 |
$35.35 |
| D1110 |
Prophylaxis - adult |
731 |
718 |
$27.84 |
| D1208 |
Topical application of fluoride, excluding varnish |
484 |
483 |
$14.79 |
| 91301 |
|
429 |
403 |
$0.00 |
| 90686 |
|
15 |
15 |
$0.00 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
25 |
25 |
$0.00 |
| 99406 |
|
106 |
83 |
$0.00 |
| V5008 |
Hearing screening |
183 |
147 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
111 |
110 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
86 |
76 |
$0.00 |
| 92551 |
|
260 |
227 |
$0.00 |
| 0012A |
|
199 |
182 |
$0.00 |
| 0001A |
|
13 |
13 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
72 |
58 |
$0.00 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
34 |
12 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
92 |
89 |
$0.00 |
| 90651 |
|
17 |
13 |
$0.00 |
| 96127 |
|
22 |
12 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
14 |
14 |
$0.00 |
| D0330 |
Panoramic radiographic image |
772 |
747 |
$0.00 |
| D1120 |
Prophylaxis - child |
401 |
400 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
268 |
229 |
$0.00 |
| 99173 |
|
270 |
190 |
$0.00 |
| 90461 |
|
130 |
81 |
$0.00 |
| 0002A |
|
28 |
27 |
$0.00 |
| 80061 |
Lipid panel |
265 |
245 |
$0.00 |
| 99072 |
|
131 |
114 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
14 |
14 |
$0.00 |
| 91300 |
|
51 |
43 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$0.00 |
| 90756 |
|
39 |
33 |
$0.00 |