| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
55,205 |
40,436 |
$1.28M |
| H1000 |
Prenatal care, at-risk assessment |
7,847 |
4,554 |
$564K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
7,430 |
5,707 |
$364K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,017 |
4,526 |
$285K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,014 |
6,710 |
$276K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,174 |
3,765 |
$257K |
| T1015 |
Clinic visit/encounter, all-inclusive |
10,029 |
5,269 |
$252K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12,179 |
9,120 |
$242K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,366 |
2,479 |
$153K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
3,226 |
1,706 |
$133K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
27,440 |
21,323 |
$65K |
| 99441 |
|
2,985 |
2,317 |
$19K |
| 97802 |
|
191 |
185 |
$17K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,647 |
1,749 |
$16K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
941 |
870 |
$14K |
| 98940 |
|
1,323 |
560 |
$13K |
| D1110 |
Prophylaxis - adult |
565 |
546 |
$13K |
| D0330 |
Panoramic radiographic image |
309 |
297 |
$12K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
958 |
766 |
$11K |
| 3074F |
|
57,734 |
35,365 |
$9K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
215 |
155 |
$8K |
| D1120 |
Prophylaxis - child |
335 |
311 |
$7K |
| D0274 |
Bitewings - four radiographic images |
1,080 |
1,040 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,643 |
1,545 |
$7K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
218 |
160 |
$6K |
| 90461 |
|
10,279 |
7,180 |
$6K |
| 99442 |
|
477 |
404 |
$6K |
| 99385 |
|
82 |
62 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
264 |
118 |
$5K |
| 0002A |
|
99 |
97 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
7,079 |
4,451 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
46 |
41 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
27 |
27 |
$2K |
| 0001A |
|
83 |
82 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
20 |
17 |
$2K |
| D1206 |
Topical application of fluoride varnish |
371 |
347 |
$2K |
| 0071A |
|
64 |
59 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
50 |
28 |
$2K |
| 96127 |
|
18,940 |
10,528 |
$2K |
| 90686 |
|
13,327 |
10,550 |
$2K |
| D1330 |
|
1,561 |
1,455 |
$1K |
| 0072A |
|
43 |
30 |
$1K |
| D7140 |
Extraction, erupted tooth or exposed root |
33 |
25 |
$1K |
| D4341 |
|
54 |
38 |
$989.62 |
| 86580 |
|
977 |
614 |
$715.97 |
| 99422 |
|
80 |
74 |
$658.73 |
| 1126F |
|
36,485 |
19,238 |
$595.71 |
| D0140 |
Limited oral evaluation - problem focused |
76 |
71 |
$585.56 |
| D0120 |
Periodic oral evaluation - established patient |
153 |
130 |
$554.18 |
| T1017 |
Targeted case management, each 15 minutes |
16 |
14 |
$540.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
328 |
220 |
$506.26 |
| 90474 |
|
615 |
402 |
$496.00 |
| 90633 |
|
2,159 |
1,711 |
$492.20 |
| 0011A |
|
13 |
12 |
$440.00 |
| 0012A |
|
24 |
16 |
$417.60 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
178 |
128 |
$379.13 |
| 90480 |
|
33 |
33 |
$320.00 |
| 90651 |
|
1,671 |
1,304 |
$315.01 |
| 98968 |
|
45 |
28 |
$304.27 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
267 |
220 |
$300.54 |
| 3075F |
|
1,151 |
544 |
$300.00 |
| 92551 |
|
13,141 |
9,242 |
$290.20 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
97 |
93 |
$274.00 |
| 90671 |
|
791 |
776 |
$264.97 |
| 96161 |
|
1,771 |
911 |
$218.82 |
| 91300 |
|
41 |
39 |
$163.20 |
| 90681 |
|
493 |
365 |
$125.00 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
47 |
44 |
$112.04 |
| G0283 |
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care |
402 |
118 |
$96.11 |
| 3078F |
|
55,218 |
33,544 |
$91.76 |
| 81025 |
|
51 |
49 |
$90.78 |
| 82962 |
|
228 |
214 |
$50.54 |
| 87807 |
|
12 |
12 |
$47.74 |
| 1160F |
|
78,321 |
42,941 |
$39.15 |
| 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 |
592 |
447 |
$34.00 |
| 1036F |
|
34,684 |
24,069 |
$26.05 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
87 |
44 |
$24.00 |
| 97010 |
|
40 |
26 |
$16.00 |
| 90648 |
|
2,850 |
2,041 |
$10.00 |
| 90734 |
|
398 |
300 |
$10.00 |
| 90723 |
|
2,571 |
1,798 |
$7.20 |
| D0220 |
Intraoral - periapical first radiographic image |
148 |
139 |
$4.00 |
| 81003 |
|
41 |
37 |
$2.02 |
| 99177 |
|
12,072 |
8,155 |
$0.80 |
| 1159F |
|
64,566 |
34,582 |
$0.00 |
| 3725F |
|
27,348 |
18,922 |
$0.00 |
| 1100F |
|
431 |
370 |
$0.00 |
| 90710 |
|
703 |
501 |
$0.00 |
| 3077F |
|
891 |
425 |
$0.00 |
| 3288F |
|
255 |
249 |
$0.00 |
| 90670 |
|
3,831 |
2,545 |
$0.00 |
| 1158F |
|
4,006 |
3,216 |
$0.00 |
| 90715 |
|
116 |
68 |
$0.00 |
| 4001F |
|
105 |
92 |
$0.00 |
| 90700 |
|
27 |
27 |
$0.00 |
| 90707 |
|
15 |
15 |
$0.00 |
| 90661 |
|
15 |
15 |
$0.00 |
| 1170F |
|
4,294 |
3,445 |
$0.00 |
| 3008F |
|
72,115 |
47,845 |
$0.00 |
| 3079F |
|
3,319 |
1,685 |
$0.00 |
| 3044F |
|
555 |
508 |
$0.00 |
| 3080F |
|
558 |
227 |
$0.00 |
| 1125F |
|
684 |
418 |
$0.00 |
| 1111F |
|
1,957 |
1,806 |
$0.00 |
| 90696 |
|
25 |
25 |
$0.00 |
| 1157F |
|
28 |
27 |
$0.00 |
| 3014F |
|
98 |
92 |
$0.00 |
| 90716 |
|
16 |
16 |
$0.00 |
| 90620 |
|
228 |
184 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
45 |
45 |
$0.00 |
| 99024 |
|
12 |
12 |
$0.00 |
| 1034F |
|
14 |
12 |
$0.00 |