| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,894 |
19,744 |
$3.20M |
| D0999 |
Unspecified diagnostic procedure, by report |
8,121 |
7,114 |
$1.88M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,445 |
4,061 |
$577K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,285 |
3,059 |
$495K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
405 |
391 |
$71K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
374 |
363 |
$70K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,246 |
3,197 |
$65K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
324 |
320 |
$57K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
253 |
244 |
$34K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
254 |
254 |
$32K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
209 |
205 |
$29K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
147 |
146 |
$24K |
| H0031 |
Mental health assessment, by non-physician |
602 |
417 |
$24K |
| D0120 |
Periodic oral evaluation - established patient |
1,074 |
1,040 |
$23K |
| D0220 |
Intraoral - periapical first radiographic image |
1,608 |
1,551 |
$18K |
| D0274 |
Bitewings - four radiographic images |
607 |
597 |
$17K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
117 |
114 |
$17K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
780 |
602 |
$17K |
| 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 |
767 |
617 |
$16K |
| 90832 |
Psychotherapy, 30 minutes with patient |
161 |
78 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,299 |
1,277 |
$14K |
| D1110 |
Prophylaxis - adult |
478 |
468 |
$14K |
| 90686 |
|
640 |
630 |
$13K |
| 90791 |
Psychiatric diagnostic evaluation |
101 |
65 |
$11K |
| D1351 |
Sealant - per tooth |
547 |
193 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
235 |
228 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
138 |
134 |
$5K |
| 99215 |
Prolong outpt/office vis |
65 |
63 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,035 |
1,008 |
$4K |
| D0190 |
|
471 |
449 |
$4K |
| D1120 |
Prophylaxis - child |
110 |
104 |
$3K |
| D0330 |
Panoramic radiographic image |
65 |
64 |
$3K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
142 |
128 |
$3K |
| 99000 |
|
2,035 |
1,970 |
$1K |
| D0145 |
Oral evaluation for a patient under three years of age |
47 |
47 |
$1K |
| D1206 |
Topical application of fluoride varnish |
2,645 |
2,511 |
$1K |
| D1353 |
|
54 |
29 |
$914.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
12 |
12 |
$792.00 |
| H0023 |
Behavioral health outreach service (planned approach to reach a targeted population) |
40 |
25 |
$681.52 |
| 90682 |
|
14 |
13 |
$639.59 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
169 |
167 |
$621.74 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
27 |
19 |
$612.00 |
| 90461 |
|
167 |
166 |
$394.13 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,505 |
1,407 |
$281.90 |
| 36415 |
Collection of venous blood by venipuncture |
3,563 |
3,367 |
$198.29 |
| 81003 |
|
339 |
296 |
$0.00 |
| 81025 |
|
179 |
173 |
$0.00 |
| 82948 |
|
14 |
14 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
15 |
12 |
$0.00 |
| 99201 |
|
43 |
42 |
$0.00 |
| 36416 |
|
317 |
300 |
$0.00 |
| 85018 |
|
165 |
159 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
38 |
34 |
$0.00 |