| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
62,610 |
53,089 |
$2.22M |
| H1000 |
Prenatal care, at-risk assessment |
16,738 |
11,669 |
$788K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
10,173 |
8,864 |
$776K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
6,495 |
5,885 |
$514K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,134 |
2,599 |
$206K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,196 |
4,504 |
$198K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,869 |
4,236 |
$148K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,620 |
1,394 |
$109K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,783 |
8,830 |
$64K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
11,584 |
9,508 |
$58K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,731 |
4,014 |
$54K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
5,766 |
1,372 |
$47K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
810 |
650 |
$42K |
| D0330 |
Panoramic radiographic image |
2,054 |
1,775 |
$37K |
| D0210 |
Intraoral - complete series of radiographic images |
1,237 |
1,192 |
$35K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,755 |
4,185 |
$29K |
| D1120 |
Prophylaxis - child |
2,199 |
1,729 |
$28K |
| 99381 |
|
447 |
355 |
$28K |
| 59430 |
|
817 |
633 |
$27K |
| 3074F |
|
22,816 |
18,170 |
$27K |
| D1110 |
Prophylaxis - adult |
1,265 |
1,183 |
$27K |
| D1330 |
|
6,372 |
5,350 |
$22K |
| 99401 |
|
1,783 |
1,583 |
$17K |
| 90670 |
|
1,760 |
1,383 |
$16K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,169 |
2,929 |
$16K |
| D0120 |
Periodic oral evaluation - established patient |
1,590 |
1,243 |
$16K |
| 99383 |
|
263 |
208 |
$16K |
| D0191 |
|
2,272 |
2,083 |
$15K |
| 76801 |
|
456 |
357 |
$15K |
| 90671 |
|
665 |
594 |
$14K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
404 |
201 |
$14K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
200 |
187 |
$13K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
609 |
382 |
$12K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
534 |
342 |
$11K |
| 90461 |
|
4,638 |
3,155 |
$11K |
| D0140 |
Limited oral evaluation - problem focused |
1,480 |
1,341 |
$11K |
| 98940 |
|
655 |
239 |
$11K |
| D1351 |
Sealant - per tooth |
3,244 |
903 |
$11K |
| 81025 |
|
6,065 |
5,171 |
$10K |
| 99384 |
|
215 |
157 |
$10K |
| 90832 |
Psychotherapy, 30 minutes with patient |
306 |
206 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
860 |
732 |
$8K |
| D7140 |
Extraction, erupted tooth or exposed root |
235 |
184 |
$7K |
| D1208 |
Topical application of fluoride, excluding varnish |
942 |
899 |
$6K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
234 |
153 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
92 |
79 |
$5K |
| D0274 |
Bitewings - four radiographic images |
1,865 |
1,566 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
5,528 |
4,577 |
$5K |
| D1206 |
Topical application of fluoride varnish |
4,523 |
3,676 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
74 |
66 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
30 |
25 |
$3K |
| 81002 |
|
4,470 |
3,089 |
$3K |
| 99386 |
|
55 |
45 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
5,540 |
4,571 |
$3K |
| 90697 |
|
873 |
757 |
$3K |
| 92558 |
|
410 |
396 |
$3K |
| 3075F |
|
1,800 |
1,523 |
$3K |
| 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 |
2,007 |
1,460 |
$3K |
| 83655 |
|
676 |
625 |
$3K |
| 81003 |
|
8,561 |
6,926 |
$2K |
| 90686 |
|
1,028 |
826 |
$2K |
| 0012A |
|
81 |
78 |
$2K |
| D0190 |
|
690 |
618 |
$2K |
| 82962 |
|
4,381 |
3,594 |
$2K |
| 99215 |
Prolong outpt/office vis |
19 |
18 |
$2K |
| 99385 |
|
37 |
30 |
$2K |
| 90633 |
|
1,032 |
848 |
$2K |
| 90647 |
|
563 |
448 |
$2K |
| 0011A |
|
87 |
82 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
28 |
24 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
342 |
269 |
$1K |
| D0603 |
|
3,734 |
3,218 |
$1K |
| 90681 |
|
527 |
471 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
790 |
616 |
$1K |
| 87428 |
|
91 |
86 |
$1K |
| 90474 |
|
327 |
301 |
$1K |
| 90661 |
|
99 |
96 |
$934.69 |
| 90715 |
|
138 |
111 |
$868.47 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
57 |
52 |
$761.92 |
| D9999 |
Unspecified adjunctive procedure, by report |
30 |
30 |
$750.00 |
| 90651 |
|
577 |
423 |
$695.57 |
| 85018 |
|
1,662 |
1,496 |
$684.31 |
| D0999 |
Unspecified diagnostic procedure, by report |
47 |
45 |
$660.00 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
18 |
12 |
$500.80 |
| 3078F |
|
17,751 |
13,432 |
$445.90 |
| 99173 |
|
4,214 |
3,489 |
$407.24 |
| 90710 |
|
113 |
81 |
$397.67 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
40 |
35 |
$365.08 |
| 90834 |
Psychotherapy, 45 minutes with patient |
60 |
37 |
$314.71 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
15 |
15 |
$308.07 |
| 92551 |
|
2,009 |
1,790 |
$280.78 |
| 90660 |
|
12 |
12 |
$225.85 |
| D0272 |
Bitewings - two radiographic images |
717 |
485 |
$213.52 |
| 90734 |
|
314 |
246 |
$211.20 |
| 3079F |
|
6,109 |
4,891 |
$203.60 |
| 90723 |
|
297 |
184 |
$201.40 |
| 11056 |
|
12 |
12 |
$194.56 |
| 92587 |
|
873 |
543 |
$191.32 |
| 90674 |
|
69 |
52 |
$165.16 |
| 90716 |
|
47 |
43 |
$156.00 |
| 90696 |
|
25 |
25 |
$152.00 |
| 90707 |
|
41 |
39 |
$136.00 |
| D0602 |
|
417 |
395 |
$135.78 |
| 90656 |
|
99 |
94 |
$91.28 |
| D0601 |
|
1,239 |
1,166 |
$65.90 |
| 1160F |
|
39,228 |
32,623 |
$63.53 |
| 3008F |
|
39,466 |
31,742 |
$59.39 |
| 2001F |
|
56,973 |
46,144 |
$51.40 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$49.65 |
| 1159F |
|
39,920 |
33,196 |
$43.13 |
| 3044F |
|
2,086 |
1,767 |
$40.00 |
| 90700 |
|
27 |
24 |
$32.00 |
| 2000F |
|
44,177 |
35,153 |
$21.93 |
| 87400 |
|
56 |
52 |
$19.98 |
| 36416 |
|
626 |
499 |
$15.00 |
| 96127 |
|
1,376 |
1,234 |
$10.17 |
| D9430 |
|
95 |
86 |
$7.24 |
| 1000F |
|
22,880 |
19,621 |
$4.17 |
| 1220F |
|
16,845 |
14,786 |
$0.02 |
| 1126F |
|
8,890 |
7,429 |
$0.01 |
| 3077F |
|
1,067 |
764 |
$0.00 |
| 99188 |
|
194 |
177 |
$0.00 |
| 4013F |
|
82 |
77 |
$0.00 |
| 2028F |
|
453 |
422 |
$0.00 |
| 90756 |
|
89 |
76 |
$0.00 |
| 0502F |
|
1,163 |
574 |
$0.00 |
| 4035F |
|
180 |
163 |
$0.00 |
| 4025F |
|
28 |
27 |
$0.00 |
| 90713 |
|
24 |
14 |
$0.00 |
| 3210F |
|
14 |
13 |
$0.00 |
| 4145F |
|
38 |
38 |
$0.00 |
| 1039F |
|
13 |
12 |
$0.00 |
| 3280F |
|
48 |
48 |
$0.00 |
| 90648 |
|
18 |
12 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
24 |
12 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
52 |
39 |
$0.00 |
| 4037F |
|
340 |
330 |
$0.00 |
| 2010F |
|
35,811 |
31,825 |
$0.00 |
| 1036F |
|
9,046 |
8,003 |
$0.00 |
| 3351F |
|
819 |
797 |
$0.00 |
| 4000F |
|
8,168 |
7,226 |
$0.00 |
| D1310 |
|
1,386 |
1,197 |
$0.00 |
| 0501F |
|
246 |
187 |
$0.00 |
| 4060F |
|
2,445 |
441 |
$0.00 |
| 1034F |
|
430 |
407 |
$0.00 |
| 4010F |
|
769 |
598 |
$0.00 |
| 1157F |
|
638 |
262 |
$0.00 |
| 1055F |
|
2,070 |
1,972 |
$0.00 |
| D4999 |
|
274 |
266 |
$0.00 |
| 1111F |
|
12 |
12 |
$0.00 |
| 1125F |
|
445 |
374 |
$0.00 |
| 4050F |
|
176 |
171 |
$0.00 |
| 3080F |
|
331 |
237 |
$0.00 |
| 99000 |
|
367 |
230 |
$0.00 |
| 0500F |
|
94 |
57 |
$0.00 |
| 0503F |
|
150 |
91 |
$0.00 |
| 90698 |
|
14 |
12 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
48 |
36 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
34 |
26 |
$0.00 |
| 4008F |
|
14 |
14 |
$0.00 |
| 1030F |
|
51 |
51 |
$0.00 |
| 3353F |
|
14 |
14 |
$0.00 |